我国首例孕妇感染高致病性禽流感(H5N1)的病原学研究The Firstly Confirmed Pregnant Woman Case of Avian Influenza A(H5N1) by Etiological Research in China
柳燕;李群;何益新;张烨;温乐英;王敏;胡万富;马明英;汪道发;刘丽萍;何军;胡守奎;任军;
摘要(Abstract)：
对2005年11月8日安徽省铜陵市人民医院报告的一例孕妇不明原因肺炎病例的死亡病因进行研究。采集病人的气管吸出物及血液标本,用RT-PCR和Real-ti me PCR方法检测流感病毒A/M、A/H5N1、A/H7N7、A/H9N1亚型特异性核苷酸片段;气管吸出物接种SPF鸡胚进行病毒分离,并对分离物进行鉴定和序列测定及分析;利用血凝抑制试验检测血清标本抗体。结果表明病人气管吸出物可以检测到甲型流感病毒M片段及H5亚型的特异性HA基因。2005年11月9日采集的血清标本用Real-ti me PCR检测到甲型流感病毒M基因。从病人的气管吸出物中分离到H5N1病毒(A/Anhui/1/2005),对病毒的HA基因序列结果进行分析表明病毒是禽源的,其主要依据是受体结合位点第226228位氨基酸位点(QSG)为禽流感病毒所特异,HA受体连接肽仍为9个碱性氨基酸(LRERRRKRP);基因进化树分析显示,HA基因与禽源病毒进化距离接近。发病后7、8、9d的血清H5N1禽流感病毒HI抗体小于20。对该病例的病原学研究证明,该病例为H5N1禽流感感染病例。
关键词(KeyWords)： 禽流感;H5N1亚型;实验研究
基金项目(Foundation):
作者(Authors): 柳燕;李群;何益新;张烨;温乐英;王敏;胡万富;马明英;汪道发;刘丽萍;何军;胡守奎;任军;
参考文献(References)：
- [1]Yuen K Y,Chan P K S,Peiris M,et al.Clinical featuresand rapid viral diagnosis of human disease associated withavian influenza A H5N1 virus[J].Lancet,1998,351:467-471.
- [2]WHO.Cumulative number of confirmed human cases ofavian influenza A/(H5N1)reported to WHO[DB].ht-tp://www.who.int/csr/disease/avian-influenza/country/cases_table_2006_2_6/en/i ndex.html(accessed Feb6.2006)
- [3]中国疾病预防控制中心.全国流感/人禽流感监测实施方案[DB].http://www.chinacdc.net.cn/n272442/272530/n294276/index.html(2005.8.19).
- [4]Cheng C Y,Poon L L M,Lau A S,et al.Induction ofproinflammatory cytokines in human macrophages by in-fluenza A(H5N1)viruses:a mechanism for the unusualseverity of human dieases?[J].Lancet,2002,360:1831-1837.
- [5]Chan M C W,Cheng C Y,Chui W H,et al.Proinflam-matory cytokine responses induced by influenza A(H5N1)viruses in primary human aloveolar and bronchi-al epithelial cells[J].Resp Res,2005,6:135.articleURL:http://respiratory-research.com/content/6/1/135(2005.11.20)
- [6]Katz J M,Lim W,Bridges C B,et al.Antibody responsein individuals infected with avian influenza A(H5N1)vi-ruses and detection of anti-H5 antibody among householdand social contacts[J].J Infect Dis,1999,180:1763-1770.
- [7]WHO animal influenza training manual.The nationaltraining course on animal influenza diagnosis and surveil-lance[DB].Harbin,China,2001,49-51.
- [8]Stephesen I,Wood J M,Nicholson K G,et al.Sialic acidreceptor specificity on erythrocytes affects detection ofantibody to avian influenza haemagglutinin[J].J MedVirol,2003,70:391-398.