CAJ | 학술논문

目的：了解人冠状病毒（HCoV）在上海地区下呼吸道感染住院患儿中的流行情况及临床特点。方法回顾性分析2009年10月至2012年9月因急性下呼吸道感染住院的5岁以下患儿554例，采用 Seeplex RV12 ACE 试剂盒检测鼻咽分泌物标本中的 HCoV 以及其他呼吸道病毒。反转录PCR 进行 HCoV-229E、HCoV-OC43、严重急性呼吸综合征（SARS）-CoV、HCoV-NL63、HCoV-HKU1和 MERS-CoV 检测，采用2种实时定量 PCR 进一步筛查中东呼吸综合征（MERS）-CoV。应用MEGA5．0软件进行序列拼接比对及进化树分析。结果554份标本中，273份病毒检测阳性，占48．56％。HCoV 阳性18份，占3．25％，其中13份为 HCoV-OC43／HKU1阳性，5份为 HCoV-229E／NL63阳性，未检测到高致病性 MERS-CoV 和 SARS-CoV。18例感染 HCoV 患儿月龄为1～48个月，男12例，女6例。临床表现为发热17例，咳嗽11例，气促9例，需要接受氧疗7例，喘息1例。6例来自ICU，12例来自普通内科病房。2例来自普通内科病房患儿同时合并腺病毒和人鼻病毒感染。18例患儿均治愈、好转出院。6例于秋季感染，5例于冬季感染，3例于春季感染，4例于夏季感染。8份 HCoV阳性标本进行测序分析，分属于 HKU1和229E 亚型各3株，分属于 OC43和 NL63亚型各1株。结论上海地区5岁以下急性下呼吸道感染患儿鼻咽分泌物标本中可分离到 HCoV，未检测到高致病性MERS-CoV；感染患儿临床表现较重但预后良好。
목적：료해인관상병독（HCoV）재상해지구하호흡도감염주원환인중적류행정황급림상특점。방법회고성분석2009년10월지2012년9월인급성하호흡도감염주원적5세이하환인554례，채용 Seeplex RV12 ACE 시제합검측비인분비물표본중적 HCoV 이급기타호흡도병독。반전록PCR 진행 HCoV-229E、HCoV-OC43、엄중급성호흡종합정（SARS）-CoV、HCoV-NL63、HCoV-HKU1화 MERS-CoV 검측，채용2충실시정량 PCR 진일보사사중동호흡종합정（MERS）-CoV。응용MEGA5．0연건진행서렬병접비대급진화수분석。결과554빈표본중，273빈병독검측양성，점48．56％。HCoV 양성18빈，점3．25％，기중13빈위 HCoV-OC43／HKU1양성，5빈위 HCoV-229E／NL63양성，미검측도고치병성 MERS-CoV 화 SARS-CoV。18례감염 HCoV 환인월령위1～48개월，남12례，녀6례。림상표현위발열17례，해수11례，기촉9례，수요접수양료7례，천식1례。6례래자ICU，12례래자보통내과병방。2례래자보통내과병방환인동시합병선병독화인비병독감염。18례환인균치유、호전출원。6례우추계감염，5례우동계감염，3례우춘계감염，4례우하계감염。8빈 HCoV양성표본진행측서분석，분속우 HKU1화229E 아형각3주，분속우 OC43화 NL63아형각1주。결론상해지구5세이하급성하호흡도감염환인비인분비물표본중가분리도 HCoV，미검측도고치병성MERS-CoV；감염환인림상표현교중단예후량호。
Objective To investigate the epidemiological and clinical characteristics of human coronovirus (HCoV ) infection in hospitalized children with acute lower respiratory tract infection (ALRTI)in Shanghai.Methods A retrospective cohort study was conducted between October 2009 and September 2012.Five hundred and fifty-four cases of ALRTI in children under 5 years were enrolled. HCoV and other respiratory viruses in archival nasopharyngeal aspirate specimens were detected by a commercial Seeplex RV12 ACE detection kit.HCoV pan-family reverse transcription polymerase chain reaction (PCR)was performed to screen all known six HCoV,including HCoV-229E,HCoV-OC43, severe acute respiratory syndrome (SARS)-CoV,HCoV-NL63,HCoV-HKU1 ,and real-time PCR was performed to screen Middle East respiratory syndrome (MERS)-CoV.MEGA5 .0 software was used to perform sequence alignment and phylogenetic tree analysis.Results In 554 samples,at least one virus was identified in 273 cases (48.56%)and HCoV was detected in 18 cases (3.25 %),among which 13 were HCoV-OC43/HKU1 positive,5 HCoV-229E/NL63 positive.No high pathogenic MERS-CoV and SARS-CoV were detected.The median age of 18 children with HCoV infection was 18 months (1 -48 months)with 12 boys and 6 girls.Seventeen cases had fever,11 cough,9 tachypenea and 1 wheeze. Seven received oxygen therapy,and 6 were admitted to intensive care unit for treatment.Two who was in ordinary ward were coinfected with adenovirus and human rhinovirus.All 18 cases recovered or improved on discharge.Six was infected in autumn,5 in winter,3 in spring and 4 in summer.Of 8 HCoV-positive samples which were sequenced,each 3 samples belonged to HKU1 and 229E subtypes,respectively,and each 1 belonged to OC43 and NL63 subtypes,respectively.Conclusions HCoV is a relatively common viral pathogen among hospitalized young children with ALRTI in Shanghai.No high pathogenic MERS-CoV is detected.HCoV can cause severe infection with favorable outcome.