信阳地区新布尼亚病毒感染状况的横断面调查

发布时间：2018-06-03 01:37

本文选题：发热伴血小板减少综合征新布尼亚病毒 + 酶联免疫吸附实验　；参考：《郑州大学》2017年硕士论文

【摘要】：发热伴血小板减少综合征(Severe Fever with Thrombocytopenia Syndrome,SFTS)是近年来新发现的一种传染病,新布尼亚病毒(New Bunyavirus)是该病的病原体[1-2]。河南省是我国乃至全世界首次发现SFTS的地区,也是报告病例数最多的地区[1,3],目前尚无我省SFTS流行地区自然人群中新布尼亚病毒的抗体水平及隐性感染状况报告。信阳市作为我省SFTS发病数最多的地区[4],是SFTS理想的研究现场。目的:通过调查我省SFTS流行地区新布尼亚病毒的抗体水平及隐性感染状况,了解人群中新布尼亚病毒的自然感染率和人群免疫状况,为我省SFTS疫情防控提供依据。方法:本次调查采用分层随机抽样法,最终在信阳市的平桥区和新县各选取7个自然村作为调查点;于2016年4月~5月在调查点采集调查对象的血清标本;采用酶联免疫吸附法(enzyme-linked immunosorbent assay,ELISA)对标本进行新布尼亚病毒特异性IgG和IgM抗体检测;根据采集标本信息对检测结果进行分类整理,应用统计学分析方法,研究新布尼亚病毒特异性抗体在不同性别、不同年龄组、不同地区人群中的分布情况。对IgM抗体阳性的血清标本,采用荧光定量PCR(Real-time PCR)进行新布尼亚病毒核酸检测,同时采用细胞培养技术进行病毒分离并鉴定;于标本采集1个月后,对所有IgM抗体阳性者逐一进行随访,确证其是否为隐性感染者。结果:本次横断面调查在信阳地区共抽取调查对象1463人,平桥区695人,新县768人;男性409人,女性1054人;年龄分布从2岁到95岁,年龄中位数为60岁。1463名被调查者中,新布尼亚病毒IgG抗体阳性者有153人,总体阳性率为10.46%(153/1463),平桥区和新县分别为7.19%(50/695)和13.41%(103/768),差异有统计学意义(P0.05);不同性别和不同年龄组间IgG抗体阳性率差异无统计学意义(P0.05)。新布尼亚病毒IgM抗体阳性者有12人,总体阳性率为0.82%(12/1463),平桥区和新县分别为0.43%(3/695)和1.17%(9/768),差异无统计学意义(P0.05);不同性别和不同年龄组间IgM抗体阳性率差异也无统计学意义(P0.05)。12份IgM抗体阳性血清标本中,新布尼亚病毒核酸阳性标本有6份;经细胞培养,成功从5份血清标本中分离出新布尼亚病毒,病毒分离率为41.67%(5/12),其中平桥1份,新县4份。距标本采集1个月后随访,IgM抗体阳性者均无SFTS临床症状出现,确系隐性感染者。结论:信阳地区自然人群中新布尼亚病毒Ig G抗体水平较高,人群中新布尼亚病毒感染的流行强度较强,新布尼亚病毒感染谱中存在隐性感染或病毒携带者,人群有较高的新布尼亚病毒潜在感染风险。
[Abstract]:Fever with thrombocytopenia syndrome (Severe Fever with Thrombocytopenia Syndromeg SFTS) is a newly discovered infectious disease in recent years, and New Bunyavirusis is the pathogen of the disease [1-2]. Henan Province is the region where SFTS was first discovered in China and the whole world, and also the region with the largest number of reported cases. At present, there is no report on the antibody level and recessive infection of Neobunia virus in the natural population of SFTS epidemic area in Henan Province. Xinyang is the region with the highest incidence of SFTS in our province [4], which is an ideal site for SFTS research. Objective: to investigate the level of antibody and recessive infection of Neobunia virus in epidemic area of SFTS in our province, to understand the natural infection rate and immune status of new Bunia virus in population, and to provide the basis for the prevention and control of SFTS epidemic situation in our province. Methods: stratified random sampling method was used to select 7 natural villages in Pingqiao District and Xinxian County of Xinyang City, and serum samples were collected from April to May 2016. Enzyme-linked immunosorbent assaysa was used to detect the specific IgG and IgM antibodies of new Bunia virus, and the results were classified and sorted according to the information collected from the samples, and the statistical analysis method was used. To study the distribution of specific antibodies against NBV in different gender, age groups and different regions. The new Bunia virus nucleic acid was detected by fluorescence quantitative PCR(Real-time PCR, and the virus was isolated and identified by cell culture technique. All patients with positive IgM antibody were followed up one by one to confirm whether they were recessive infection. Results: a total of 1463 subjects were selected from this cross-sectional survey, including 695 in Pingqiao District, 768 in Xinxian County, 409 in males and 1054 in females. The age distribution ranged from 2 to 95 years old, with a median age of 60 years. The positive rate of IgG antibody in Pingqiao district and Xinxian county was 7.1950 / 695 and 13.41 / 103 / 768, respectively. The difference was statistically significant (P 0.05), but there was no significant difference in the positive rate of IgG antibody between different sex and different age groups (P 0.05). There are 12 people who are positive for IgM antibodies to the New Bunia virus. The overall positive rate was 0.82% 1463%, 0.43% in Pingqiao District and 0.43% in Xinxian County, respectively. There was no significant difference in the positive rate of IgM antibody between the two groups (P 0.05). There was no significant difference in the positive rate of IgM antibody among different sex and age groups. New Bunia virus was isolated from 5 serum samples by cell culture. The isolation rate of the virus was 41.675 / 12, of which 1 was Pinqiao and 4 were Xinxian. One month after the collection of specimens, no clinical symptoms of SFTS were found in all the patients who were positive for IgM antibody, and they were indeed recessive infected. Conclusion: the level of IgG antibody to neobonia virus in natural population in Xinyang area is high, and the epidemic intensity of new Bunia virus infection in population is stronger. There is recessive infection or virus carrier in infection spectrum of new Bunia virus. The population has a higher risk of potential new Bunia virus infection.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R512.8;R181.3

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