婴幼儿呼吸道合胞病毒感染严重程度与基因分型及血清炎症因子水平的相关性

目的 探讨婴幼儿呼吸道合胞病毒(respiratory syncytial virus,RSV)感染严重程度与病毒基因分型及血清IL10、IL17、IL27水平的相关性。 方法 选取2017年3月1日至2018年3月1日我院收治的77例呼吸道合胞病毒感染患儿作为研究对象,对患儿鼻咽部位的分泌物进行取样,对呼吸道合胞病毒亚型和基因型进行检测,按照病情的严重程度,将患者分为轻度组、中度组和重度组。对各组患儿病情程度,RSV亚型分布及血清IL10、IL17、IL27水平进行比较。 结果 轻度组患儿病情评分为(1.22±0.11)分,中度组为(4.89±0.98)分,重度组为(7.08±0.97)分。77份RSV阳性标本共检出A亚型48例,B亚型29例,其中轻度组、中度组及重度组患者中的A亚型感染人数比例分别为52.17%,60.00%,78.95%。A亚型病毒中NA1型为优势基因型。重度组患儿中NA1型的比例显著高于中度组和轻度组。B亚型病毒中BA9为优势基因型。轻度组患儿BA9型比例显著高于中度组和重度组。轻度组患儿血清IL10、IL17、IL27水平最低,重度组IL10、IL17、IL27的水平最高(均P结论 不同病情程度呼吸道合胞病毒感染患儿其病毒基因型分布及血清炎症因子的水平存在显著差异,病毒基因型与疾病的严重程度具有相关性。病毒基因型及血清炎症因子的水平可以作为判断此类患儿病程的标志物。

Correlation between severity, genotyping and serum inflammatory factors in infants and children with respiratory syncytial virus infection

Objective To explore the correlation between severity, genotyping and serum levels of IL10, IL17 and IL27 in infants and children with respiratory syncytial virus (RSV) infection. Methods A total of 77 infants/children infected with RSV who admitted in our hospital from March 1,2017 to March 1,2018 were enrolled. The secretions of nasopharynx were sampled and the subtypes and genotypes of RSV were detected. According to the severity of the disease, the patients were divided into mild, moderate or severe group. The severity of RSV infection, the distribution and changes of RSV subtypes and the levels of serum inflammatory factors were compared among groups. Results The disease severity score was (1.22±0.11) in mild group, (4.89±0.98) in moderate group and (7.08±0.97) in severe group. A subtype virus was detected in 48 while B subtype in 27 of the 77 RSV positive samples. The prevalence of A subtype virus in mild, moderate and severe groups were 52.17%, 60.00% and 78.95% respectively. In subtype A, NA1 was the dominant genotype. The proportion of NA1 in severe group was much higher than that in moderate and mild group respectively. In subtype B, BA9 was the dominant genotype. The proportion of BA9 genotype in mild group was higher than that in moderate group and severe group respectively. The levels of IL10, IL17 and IL27 were the lowest in mild group and the highest in severe group (all PConclusion There are significant differences in virus genotype and levels of serum inflammatory factors in different disease degrees of RSA infection in infants/children. The virus genotype was correlated with the severity of the disease. The virus genotype and serum inflammatory factors can be used as markers to assess the course of disease.