摘要
目的研究黑龙江省肾综合征出血热病毒基因序列特点,以期寻找近年来黑龙江省肾综合征出血热临床特点变化的原因。方法收集鼠肺标本110例及2005—2015年就诊于哈尔滨医科大学附属第一医院及齐齐哈尔市第七医院临床诊断为轻型和不典型肾综合征出血热的患者早期血标本121例,及部分典型出血热患者外周血标本100例,提取病毒核酸,进行序列扩增,电泳分析及基因测序,所得序列分型并与既往毒株基因序列进行比较,进行系统进化及同源性分析,结合核苷酸及氨基酸位点的变化,探讨肾综合征出血热临床特点变化原因。结果轻型及不典型肾综合征出血热基因序列扩增成功26例,其中HTN型14例,SEO型12例。典型肾综合征出血热标本扩增成功22例,其中HTN型19例,SEO型3例;黑龙江省人源与鼠源汉坦病毒与76-118株均存在变异,非典型病例标本、典型病例标本、鼠源汉坦病毒与标准株核苷酸同源性分别为74.4%~89.2%、87.4%~90.3%、88.1%~88.5%;人源及鼠源汉坦病毒同源性为79.7~99.1%,其中人源的Hljh38、Hljh39与其他毒株差异较大,与既往Amur病毒株H5、H8205同源性高,可达94.9%~97.6%,为同一亚型。推导的氨基酸与标准毒株比较部分位点存在变异,但未见明显的变异规律。结论黑龙江省肾综合征出血热临床特征较之前发生变化的原因与病毒型别的变化相关;同时也存在汉坦病毒变异,氨基酸位点变化,但具体变异规律及与临床表现的相关性有待进一步验证。
Objective To study the gene sequence characteristics of hantavirus in Heilongjiang Province in order to find out the reasons for the changes of clinical characteristics of hemorrhagic fever with renal syndrome in Heilongjiang Province in recent years.Methods Totally 110 rat lung specimens,121 blood specimens from patients diagnosed with mild or atypical HFRS and 100 blood specimens from patients diagnosed with typical HFRS in the First Affiliated Hospital of Harbin Medical University and the Seventh Hospital of Qiqihar City from 2005 to 2015 were collected.The gene sequences were obtained by nucleic acid extraction,RT-NestPCR,and gene sequencing.Explore the possible reasons for the changes in clinical characteristics of HFRS by comparing the obtained sequences with previous strains,homology analysis,building phylogenetic trees of M gene,and finding out the law of nucleotide and amino acid loci changes.Results TM gene of twenty-six mild or atypical HFRS patients were successfully amplified,including 14 cases of HTN type and 12 cases of SEO type;M gene of twenty-two typical HFRS patients were amplified,including 19 cases of HTN type and 3 cases of SEO type.Compared with the standard strain 76-118,the nucleotide homology of hantavirus from mild or atypical HFRS patients,typical HFRS patients and mice was 74.4%-89.2%,87.4%-90.3%and 88.1%-88.5%.Comparing hantavirus gene sequence from mice and from patients,the nucleotide homology was 79.7-99.1%.Hljh38 and Hljh39 from patients were significantly different from the other strains.They were the same subtype as Amur virus because they had high homology with Amur strains H5 and H8205(94.9%-97.6%).The deduced amino acids showed some variations compared with the standard strains,but no obvious variation law was observed.Conclusion The reason for the changes of clinical characteristics of hemorrhagic fever with renal syndrome in Heilongjiang province is related to the change of viral type.There are also variations of hantavirus and amino acid,but the relationship between specific variation law and clinical manifestations needs to be further verified.
作者
赵越
沈颖
朱可佳
陈淑红
盛欣
兰英华
ZHAO Yue;SHEN Ying;ZHU Ke-jia;CHEN Shu-hong;SHENG Xin;LAN Ying-hua(Department of Infectious Disease,the First Affiliated Hospital of Harbin Medical University,Harbin 150001,China)
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2019年第7期649-652,共4页
Chinese Journal of Practical Internal Medicine
基金
黑龙江省教育厅科学技术研究项目(12541488)
关键词
肾综合征出血热
临床特点变化
病毒变异
基因测序
系统进化树
hemorrhagic fever with renal syndrome
changesof clinical characteristic
virus variation
gene sequence
phylogenetic tree
