摘要
目的分析发热伴血小板减少综合征布尼亚病毒（SFTSV）感染患者的临床特征、流行病学以及SFTSV基因序列。方法收集2011年5月至7月在温州医学院附属舟山医院感染性疾病科收治的5例重症发热伴血小板减少综合征（sFTS）患者，均经PCR检测SFTsV核酸确诊。采用流式细胞仪（FCM）检测CD3＋CD4＋、CD3＋CD8＋T淋巴细胞，分离的病毒株测序并与GenBank比对。结果SFTS患者典型临床表现为持续高热、全身肌肉酸痛、浅表淋巴结肿大、腹痛、腹泻，可伴消化道出血，在急性期WBC、PLT、CD3＋CD4＋T淋巴细胞呈进行性下降，最低分别为（0．97～2．00）×10^9／L，（12-42）×10^9／L和7．52％420．39％。2例患者血清中分离出病毒，其基因序列与GenBank中的SFTSV进行比对，依赖RNA的RNA聚合酶基因与BX-2010、L-WWG、LN3、JS4、SD4、HN6和AH12的同源性为96％，糖蛋白基因的同源性为94％，而N蛋白基因与JS4、SD4和LN4的同源性为95%；分离的2株病毒的上述三种基因序列的同源性为99％。结论SFTSV在浙江省有散发流行，以本土疫源性可能大，起病急，病情重，伴多脏器功能损害。
Objective To investigate the clinical characteristics, epidemiology of patients with severe fever with thrombocytopenia syndrome bunyavirus （SFTSV） infection and genetic sequences of SFTSV. Methods Clinical data of five cases of severe fever with thrombocytopenia syndrome （SFTS） from Zhoushan Hospital during May 2011 to July 2011 were retrospectively analyzed. SFTSV gene was amplified by polymerase chain reaction （PCR）. CD3＋ CD4＋ and CD3＋ CD8＋ T lymphocytes were detected by flow cytometry （FCM）. The sequences of isolated SFTSV strains were compared with those in GenBank. Results The symptoms of continuous high fever, sore muscles, enlarged superficial lymph nodes, abdominal pain, diarrhea with gastrointestinal hemorrhage were observed. The white blood cells, platelets and CD3＋ CD4＋ T lymphoeytes were progressive decreased in acute phase with the minimum of （0. 97-2. 00） × 10^9/L, （12-42） × 10^9/L and 7. 52%-20. 39%, respectively. The SFTSV was isolated from the sera of two patients. The sequences were compared with SFTSV sequences in GenBank. The homology of RNA-dependent RNA polymerase gene was 96 % compared with BX-2010, L-WWG, LN3, JS4, SD4, HN6 and AH12 %the glycoprotein gene was 94% N protein gene was 95 % compared with JS4, SD4 and LN4. The homology of the above three genes between two isolates was 99%. Conelusions Our results suggest that SFTSV is sporadie in Zhejiang Province which is probably from native epidemic foeus. SFTS is progressive and severe with aeute onset. Multiple organ dysfunction is common in severe cases.
出处
《中华传染病杂志》
CAS
CSCD
北大核心
2012年第5期268-272,共5页
Chinese Journal of Infectious Diseases
基金
基金项目：国家“十一五”传染病重大专项资助项目（2009ZX10004-104）
浙江省自然科学基金资助项目（Y2091129）
