发热伴血小板减少综合征病毒感染状况调查及其传播媒介初步研究

发布时间：2018-06-15 07:45

本文选题：发热伴血小板减少综合征 + 病毒感染　；参考：《南京医科大学》2014年硕士论文

【摘要】：发热伴血小板减少综合征(SFTS)是一种由新型布尼亚病毒(SFTSV)引起的新发传染病。SFTS患者急性起病,没有特异的临床症状,主要表现为发热、乏力、恶心、呕吐等胃肠消化道症状,临床实验室检查常见血小板减少和白细胞减少,病死率超过10%。SFTS在我国多个省份均有流行,江苏省也是其中之一。因此,我们需要探讨SFTSV在自然界可能存在的传播媒介并了解其在一般人群中的感染状况和影响因素,从而为全面掌握发热伴血小板减少综合征流行特征以及制定有针对性的防控措施提供科学依据,保障公众安全。第一部分：江苏省发热伴血小板减少综合征病毒感染状况及影响因素研究目的了解和掌握江苏省一般人群SFTSV的感染状况及影响因素,为预防和控制SFTSV感染提供科学依据。方法在南京江宁区和溧水县、无锡宜兴、常州溧阳、淮安盱眙、连云港东海、徐州沛县七个地区,根据年龄特征的不同,采用分层随机抽样的方法确定调查对象开展流行病学调查,并采集血清标本进行SFTSV总抗体检测。结果共选取调查对象2510名,其中11名(0.44%)调查对象体内SFTSV总抗体为阳性。七个地区间SFTSV总抗体阳性率差异有统计学意义(Fisher确切概率法P=0.002)。不同性别和不同年龄组间SFTSV总抗体阳性率差异均无统计学意义(Fisher确切概率法P值分别为1.000和0.556)。多因素Logistic回归显示,养羊、放牧、种地三个因素与SFTSV总抗体阳性呈正相关性,是感染SFTSV的危险因素。结论人群中SFTSV抗体流行率处于较低水平,存在感染该病毒的潜在高风险。SFTSV感染存在地区差异,不存在性别易感性。进行野外作业时,养羊、放牧和种地能增加感染SFTSV的机会,有养羊、放牧和种地野外活动史的人群是防控SFTSV感染的重要对象。第二部分：发热伴血小板减少综合征病毒传播媒介的初步研究目的研究库蚊、按蚊、伊蚊经人工感染是否能传播发热伴血小板减少综合征病毒。方法试验蚊种选择淡色库蚊、中华按蚊和埃及伊蚊。用葡萄糖水、豚鼠血及发热伴血小板减少综合征病毒培养液混合制备的血模样品喂食饥饿蚊虫4小时,取吸食血模样品后4小时、24小时、48小时、72小时、96小时的雌蚊为样本进行研磨,对研磨液提取核酸后应用荧光定量PCR方法进行病毒核酸检测,检测阳性的标本用Vero细胞分离病毒及PCR鉴定。结果荧光定量PCR结果显示,吸食血模样品后4-72小时,三种蚊种体内均能检测到病毒核酸,虽然中华按蚊96小时组蚊虫体内仍有病毒核酸存在,但所有蚊虫实验组的Ct值均随实验组时间推移呈逐渐升高趋势,显示蚊体内病毒并未出现增殖。病毒分离结果发现,仅吸食血模样品4小时后的淡色库蚊研磨液能引起接种细胞病变,其余蚊虫研磨液接种细胞后均未引起接种细胞病变。结论淡色库蚊、中华按蚊和埃及伊蚊不能作为发热伴血小板减少综合征病毒的传播媒介。
[Abstract]:Fever with Thrombocytopenia syndrome (SFTS) is a new infectious disease caused by new Bunia virus (SFTSVS). It has no specific clinical symptoms, such as fever, fatigue, nausea, vomiting and other gastrointestinal symptoms. Clinical laboratory examination showed that thrombocytopenia and leukopenia were common, and the mortality rate was more than 10. S.SFTS was prevalent in many provinces of China, and Jiangsu Province was one of them. Therefore, we need to explore the possible vectors of SFTSV in nature and understand their infection status and influencing factors in the general population. So it can provide scientific basis for mastering the epidemic characteristics of fever with thrombocytopenia syndrome and making targeted prevention and control measures to ensure public safety. Part one: study on infection status and influencing factors of Fever combined with Thrombocytopenia virus in Jiangsu Province objective to understand and understand the infection status and influencing factors of SFTSV in general population in Jiangsu Province, and to provide scientific basis for prevention and control of SFTSV infection. Methods in Jiangning District and Lishui County of Nanjing, Wuxi Yixing, Changzhou Liyang, Huai'an Xuyi, Lianyungang East China Sea and Xuzhou Peixian were studied. The method of stratified random sampling was used to determine the subjects to carry out epidemiological investigation, and serum samples were collected for the detection of total antibody to SFTSV. Results A total of 2510 subjects were selected, of whom 11 were found to be positive for total antibody to SFTSV. The positive rate of total antibody of SFTSV was significantly different among the seven regions by Fisher exact probability method (P0. 002). There was no significant difference in the positive rate of total antibody of SFTSV between different sex and age groups. The exact probability of Fisher method was 1.000 and 0.556 respectively. Multivariate logistic regression analysis showed that three factors of sheep raising, grazing and cultivation were positively correlated with the total antibody positive of SFTSV, and were the risk factors of SFTSV infection. Conclusion the prevalence rate of SFTSV antibody in the population is low, and there is a regional difference in the potential high risk of SFTSV infection, and there is no gender susceptibility to SFTSV infection. In the field work, raising sheep, grazing and planting land can increase the chance of infection with SFTSV. The population with sheep raising, grazing and field activity history is the important object to prevent and control SFTSV infection. Part two: a preliminary study on the transmission vector of fever with thrombocytopenia syndrome virus objective to study whether the infection of Culex pipiens, Anopheles mosquitoes and Aedes mosquitoes can transmit febrile and thrombocytopenic syndrome virus. Methods Culex pipiens pallens, Anopheles sinensis and Aedes aegypti were selected. The starved mosquitoes were fed with glucose water, guinea pig blood and fever with thrombocytopenia syndrome virus culture medium for 4 hours. The samples of female mosquitoes, which were taken 4 hours, 24 hours, 48 hours and 72 hours and 96 hours after taking the blood sample, were ground. The nucleic acid was extracted from the grinding fluid and detected by fluorescence quantitative PCR. The positive specimens were identified by Vero cell isolation and PCR. Results the results of fluorescence quantitative PCR showed that virus nucleic acid could be detected in the three species of mosquitoes 4-72 hours after taking the blood sample, although virus nucleic acid still existed in the mosquito of Anopheles sinensis 96 hours group. However, the Ct values of all mosquito experimental groups increased gradually with the passage of time, indicating that the virus did not proliferate. The results of virus isolation showed that the inoculation cytopathic effect could be caused only by the grinding fluid of Culex pipiens pallens after 4 hours of ingestion of the blood sample, but no cytopathic effect was found in the other mosquitoes after inoculating the cells. Conclusion Culex pipiens pallens, Anopheles sinensis and Aedes aegypti cannot be used as vectors of fever with thrombocytopenia syndrome virus.
【学位授予单位】：南京医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R510

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