人感染H7N9禽流感26例临床特征与病毒基因分析研究

发布时间：2018-08-27 11:26

【摘要】：目的探讨人感染H7N9禽流感病毒患者的流行病学和临床特征,以及病毒分子生物学特征。方法收集湖南省2013、2014年确诊的26例人感染H7N9禽流感病毒患者的资料,对人和禽分离的H7N9病毒进行鉴定和测序分析。结果26例患者中,发热和咳嗽是最常见的起病症状,所有患者均存在肺炎;20例(76.92%)出现急性呼吸窘迫综合征(ARDS),25例(96.15%)初诊时白细胞下降或正常,发病至开始进行抗病毒治疗的平均时间为10 d。10例死亡,病死率达38.46%。患者分离的H7N9病毒株测序分析表明,发生了H7基因Gln226Leu和Gly186Val替换,PB2基因Asp701Asn突变。结论急性呼吸系统损害是人感染H7N9禽流感的主要临床表现,活禽暴露是人感染H7N9禽流感的重要危险因素,H7N9禽流感病毒基因发生了部分位点的适应性突变,更容易从禽类向人跨种传播引起人类严重疾病,需加强病原学监测。
[Abstract]:Objective to investigate the epidemiological and clinical characteristics and molecular biological characteristics of human H7N9 avian influenza virus. Methods data of 26 cases of human infected with H7N9 avian influenza virus confirmed in Hunan province in 2013 and 2014 were collected. The H7N9 virus isolated from human and poultry was identified and sequenced. Results among the 26 patients, fever and cough were the most common symptoms. All the patients had pneumonia in 20 cases (76.92%) with acute respiratory distress syndrome (ARDS) in 25 cases (96.15%). The average time from onset to beginning of antiviral therapy was 10 d.10 deaths with a mortality of 38.46. Sequencing analysis of H7N9 virus strains isolated from patients showed that H7 gene Gln226Leu and Gly186Val replacement PB2 gene Asp701Asn mutation occurred. Conclusion Acute respiratory system damage is the main clinical manifestation of human H7N9 avian influenza. Exposure to live poultry is an important risk factor for human H7N9 avian influenza infection. The H7N9 avian influenza virus gene has some adaptive mutations. It is easier to spread from poultry to human species and cause serious diseases in humans, so it is necessary to strengthen etiological surveillance.
【作者单位】：株洲市中心医院;株洲市疾病预防控制中心;
【分类号】：R511.7

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