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目的检测北京市H7N9禽流感病毒感染病例及密切接触者样本中H7N9流感病毒相关基因,分析不同靶基因、不同类型样本对检测结果的影响。方法收集2013年4月~7月北京市人感染H7N9禽流感病例及密切接触者咽拭子、痰、气管灌洗液、血清样本,提取病毒RNA,检测甲型流感病毒基质蛋白(influenza A matrix protein,Am)基因、血凝素-7(hemagglutinin 7,H7)基因和神经氨酸酶-9(neuraminidase 9,N9)基因,并对结果进行统计分析。结果 H7N9禽流感确诊病例样本中Am基因、H7基因和N9基因的检测阳性率分别为68.3%、66.0%和41.5%,N9基因阳性率低于前两者。在定量检测中,Am基因、H7基因和N9基因的定量限分别为10 copies/ml、10copies/ml和100 copies/ml。在各类型检测样本中,气管灌洗液样本的病毒核酸检出率较高,未在血清和结膜分泌物样本中检出病毒核酸。结论在人感染H7N9禽流感检测中,应尽量使用气管灌洗液等下呼吸道样本,综合判定检测结果,为临床治疗提供参考依据。
Objective To detect the related genes of H7N9 influenza virus in H7N9 avian influenza virus (H7N9) and close contacts in Beijing, and to analyze the influence of different target genes and different types of samples on the detection results. Methods The throat swab, sputum, tracheal lavage fluid and serum samples of H7N9 bird in Beijing from April to July 2013 were collected and the viral RNA was extracted to detect influenza A matrix protein, Am) gene, hemagglutinin 7 (H7) gene and neuraminidase 9 (N9) gene, and the results were statistically analyzed. Results The positive rates of Am gene, H7 gene and N9 gene in H7N9 bird flu were 68.3%, 66.0% and 41.5%, respectively. The positive rate of N9 gene was lower than the former two. Quantitative detection, Am gene, H7 gene and N9 gene were 10 copies / ml, 10copies / ml and 100 copies / ml. In all kinds of test samples, the detection rate of virus nucleic acid in the tracheal perfusate sample is high, and the virus nucleic acid is not detected in the serum and conjunctival secretions samples. Conclusion In the detection of H7N9 avian influenza in humans, the sample of lower respiratory tract such as tracheal lavage fluid should be used as far as possible to determine the test results comprehensively and provide a reference for clinical treatment.