慢性阻塞性肺疾病急性加重期患者的腺病毒感染及基因特征分析

陈平 徐源佑 杨燕清 杜海军 梅国勇 夏志强 董鸿铭 韩俊 陆国玉

陈平, 徐源佑, 杨燕清, 杜海军, 梅国勇, 夏志强, 董鸿铭, 韩俊, 陆国玉. 慢性阻塞性肺疾病急性加重期患者的腺病毒感染及基因特征分析[J]. 疾病监测, 2022, 37(5): 623-628. doi: 10.3784/jbjc.202112230655
引用本文: 陈平, 徐源佑, 杨燕清, 杜海军, 梅国勇, 夏志强, 董鸿铭, 韩俊, 陆国玉. 慢性阻塞性肺疾病急性加重期患者的腺病毒感染及基因特征分析[J]. 疾病监测, 2022, 37(5): 623-628. doi: 10.3784/jbjc.202112230655
Chen Ping, Xu Yuanyou, Yang Yanqing, Du Haijun, Mei Guoyong, Xia Zhiqiang, Dong Hongming, Han Jun, Lu Guoyu. Infection status and genetic characteristics of adenovirus in patients with acute exacerbation of chronic obstructive pulmonary disease[J]. Disease Surveillance, 2022, 37(5): 623-628. doi: 10.3784/jbjc.202112230655
Citation: Chen Ping, Xu Yuanyou, Yang Yanqing, Du Haijun, Mei Guoyong, Xia Zhiqiang, Dong Hongming, Han Jun, Lu Guoyu. Infection status and genetic characteristics of adenovirus in patients with acute exacerbation of chronic obstructive pulmonary disease[J]. Disease Surveillance, 2022, 37(5): 623-628. doi: 10.3784/jbjc.202112230655

慢性阻塞性肺疾病急性加重期患者的腺病毒感染及基因特征分析

doi: 10.3784/jbjc.202112230655
基金项目: 国家科技重大专项(No. 2018ZX10102001, No. 2018ZX10711001, No. 2018ZX10734404);国家病原微生物资源库(No. NPRC-32);传染病预防控制国家重点实验室发展基金(No. 2011SKLID104)
详细信息
    作者简介:

    陈平,男,重庆市人,硕士研究生,主要从事呼吸系统急重症研究,Email:cp13008308102@163.com

    通讯作者:

    韩俊,Tel:13381210388, Email:hanjun_sci@163.com

    陆国玉,Tel:13033013637, Email:1359112431@qq.com

  • 中图分类号: R211; R511

Infection status and genetic characteristics of adenovirus in patients with acute exacerbation of chronic obstructive pulmonary disease

Funds: This study was supported by the fund for National Science and Technology Major Project (No. 2018ZX10102001, No. 2018ZX10711001, No. 2018ZX10734404), National Pathogen Resource Center (No. NPRC-32) and the Development Grant of State Key Laboratory of Infection Disease Prevention and Control (No. 2011SKLID104)
More Information
  • 摘要:   目的  了解慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)患者的呼吸道病毒感染情况及腺病毒感染特点。  方法  收集2020年11月至2021年4月安徽省蚌埠市某三甲医院AECOPD住院重症患者咽拭子,采用实时荧光定量PCR(qPCR)方法筛查16种常见呼吸道病毒,对腺病毒(ADV)阳性样本扩增腺病毒六邻体基因,构建进化树。  结果  AECOPD患者呼吸道样本中呼吸道病毒检出率为38.38%(109/284),其中,ADV检出率最高,为27.81%(79/284)。 重症患者ADV感染以C1型为主,同时,有B、C和D等多个亚型存在。 结合临床数据,AECOPD患者中,感染ADV的较未感染ADV的病程长、预后差。  结论  临床应对AECOPD患者的呼吸道病毒感染情况进行有效监测,以提高诊断和治疗效果。
  • 图  1  腺病毒六邻体基因片段序列进化树

    注:红色、粉色、绿色、浅绿色、天蓝色、浅蓝色、深蓝色分别代表ADV-C1、C5、B7、B3、D17、D19、D27型序列

    Figure  1.  Gene evolution tree of adenovirus hexon gene segment

    表  1  不同年龄组慢性阻塞性肺疾病急性加重期患者的临床特征(例)

    Table  1.   Clinical characteristics of AECOPD patients among different age groups

    年龄组
    (岁)
    病例数 男性女性 慢性阻塞性肺疾病特定症状 血气分析
    咳嗽咳痰 活动气喘 Ⅰ型呼吸衰竭Ⅱ型呼吸衰竭低氧血症
    咳嗽伴咳痰干咳 mMRC3级mMRC4级
    27~83571 08 071
    50~176111073141151
    60~755718581711640714
    70~12610818982813113511110
    80~54421241135492502
    90~964312204040
    合计284 21965 20565 32252 825818
    下载: 导出CSV

    表  2  慢性阻塞性肺疾病急性加重期患者临床呼吸道症病毒感染谱

    Table  2.   Clinical spectrum of respiratory syndrome virus infection in patients with AECOPD

    感染病毒
    种类
    病毒病例数(例)
    1种腺病毒58
    巨细胞病毒8
    博卡病毒2
    鼻病毒2
    甲型流感病毒2
    呼吸合胞病毒1
    冠状病毒HUK11
    冠状病毒NL631
    冠状病毒229E1
    冠状病毒OC431
    乙型流感病毒1
    1型副流感病毒1
    3型副流感病毒1
    人偏肺病毒1
    2种腺病毒+巨细胞病毒2
    腺病毒+呼吸合胞病毒3
    腺病毒+冠状病毒HKU11
    腺病毒+冠状病毒NL632
    腺病毒+冠状病毒229E3
    腺病毒+冠状病毒OC431
    腺病毒+鼻病毒2
    腺病毒+肠道病毒3
    腺病毒+2型副流感病毒1
    腺病毒+人偏肺病毒1
    巨细胞病毒+肠道病毒1
    呼吸合胞病毒+冠状病毒229E1
    呼吸合胞病毒+乙型流感病毒1
    呼吸合胞病毒+肠道病毒1
    鼻病毒+3型副流感病毒1
    博卡病毒+肠道病毒1
    3种腺病毒+呼吸合胞病毒+3型副流感病毒1
    腺病毒+巨细胞病毒+1型副流感病毒1
    呼吸合胞病毒+肠道病毒+人偏肺病毒1
    下载: 导出CSV

    表  3  慢性阻塞性肺疾病急性加重期重症患者腺病毒感染单因素分析

    Table  3.   Univariate analysis on adenovirus infection in severe patients with AECOPD

      因素 A组(n=79)B组(n=30)C组(n=175)A组和B组比较 A组和C组比较
    统计量P 统计量P
    性别a男性64271280.7050.401 1.8270.1765
    女性15 3 47
    年龄(岁) 73.94±8.74 71.37±11.6571.16±9.83 −1.0770.282 2.04050.0413
    病程(d)17.66±7.97 14.8±10.8412.52±11.87−2.0190.0445.3345<.0001
    发热(>37.5 ℃)a4327 4711.972<0.001 18.0879<.0001
    36 3128
    白细胞计数b10.45±4.32 11.02±4.72 11.05±5.29 0.790.429−0.59590.5512
    中性粒细胞计数b6.45±3.797.00±4.107.19±4.830.5360.592−0.72330.4695
    淋巴细胞计数b1.49±0.861.55±1.051.34±0.71−0.0920.9271.26560.2056
    嗜酸性粒细胞计数b0.38±0.340.53±0.790.41±0.450.3120.755−0.00550.9956
    吸入糖皮质激素a61281583.770.0527.82660.0051
    18 2 17
    活动后气喘amMRC4级66281581.75560.18522.37480.1233
    mMRC3级13 2 17
    呼吸性衰竭a7429163/1.0000.02430.8761
    5 1 12
    心力衰竭a41 5 2811.065<0.00135.4516<0.0001
    3825147
    预后a恶化18 0 152.0640.039−8.0139<0.0001
    3919 15
    缓解2211145
    注:A组为腺病毒感染组,B组为非腺病毒感染组,C组为无病毒感染组;a. 数值为病例数(例);b. 数值为均数±标准差(×109/L);
    /. 采用fisher确切概率法
    下载: 导出CSV
  • [1] Fletcher C, Peto R. The natural history of chronic airflow obstruction[J]. Br Med J, 1977, 1(6077): 1645–1648. DOI:  10.1136/bmj.1.6077.1645.
    [2] Raherison C, Girodet PO. Epidemiology of COPD[J]. Eur Respir Rev, 2009, 18(114): 213–221. DOI:  10.1183/09059180.00003609.
    [3] Kurai D, Saraya T, Ishii H, et al. Virus-induced exacerbations in asthma and COPD[J]. Front Microbiol, 2013, 4: 293. DOI:  10.3389/fmicb.2013.00293.
    [4] Sajjan US. Susceptibility to viral infections in chronic obstructive pulmonary disease: role of epithelial cells[J]. Curr Opin Pulm Med, 2013, 19(2): 125–132. DOI:  10.1097/MCP.0b013e32835cef10.
    [5] Vogelmeier CF, Criner GJ, Martinez FJ, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive lung disease 2017 Report. GOLD executive summary[J]. Am J Respir Crit Care Med, 2017, 195(5): 557–582. DOI: 10.1164/rccm.201701−0218PP.
    [6] Jones PW, Adamek L, Nadeau G, et al. Comparisons of health status scores with MRC grades in COPD: implications for the GOLD 2011 classification[J]. Eur Respir J, 2013, 42(3): 647–654. DOI:  10.1183/09031936.00125612.
    [7] Gunson RN, Collins TC, Carman WF. Real-time RT-PCR detection of 12 respiratory viral infections in four triplex reactions[J]. J Clin Virol, 2005, 33(4): 341–344. DOI:  10.1016/j.jcv.2004.11.025.
    [8] Allander T, Jartti T, Gupta S, et al. Human bocavirus and acute wheezing in children[J]. Clin Infect Dis, 2007, 44(7): 904–910. DOI:  10.1086/512196.
    [9] Terlizzi ME, Massimiliano B, Francesca S, et al. Quantitative RT real time PCR and indirect immunofluorescence for the detection of human parainfluenza virus 1, 2, 3[J]. J Virol Methods, 2009, 160(1-2): 172–177. DOI:  10.1016/j.jviromet.2009.04.039.
    [10] Esposito S, Bosis S, Niesters HGM, et al. Impact of human coronavirus infections in otherwise healthy children who attended an emergency department[J]. J Med Virol, 2006, 78(12): 1609–1615. DOI:  10.1002/jmv.20745.
    [11] Wang SS, Zheng G, Zhao LF, et al. Shp-2 contributes to anti-RSV activity in human pulmonary alveolar epithelial cells by interfering with the IFN-α-induced Jak/Stat1 pathway[J]. J Cell Mol Med, 2015, 19(10): 2432–2440. DOI:  10.1111/jcmm.12629.
    [12] Falsey AR, Formica MA, Walsh EE. Yield of sputum for viral detection by reverse transcriptase PCR in adults hospitalized with respiratory illness[J]. J Clin Microbiol, 2012, 50(1): 21–24. DOI: 10.1128/JCM.05841−11.
    [13] Griscelli F, Barrois M, Chauvin S, et al. Quantification of human cytomegalovirus DNA in bone marrow transplant recipients by real-time PCR[J]. J Clin Microbiol, 2001, 39(12): 4362–4369. DOI: 10.1128/JCM.39.12.4362−4369.2001.
    [14] Klemenc J, Asad Ali S, Johnson M, et al. Real-time reverse transcriptase PCR assay for improved detection of human metapneumovirus[J]. J Clin Virol, 2012, 54(4): 371–375. DOI:  10.1016/j.jcv.2012.05.005.
    [15] Heim A, Ebnet C, Harste G, et al. Rapid and quantitative detection of human adenovirus DNA by real-time PCR[J]. J Med Virol, 2003, 70(2): 228–239. DOI:  10.1002/jmv.10382.
    [16] Blumental S, Reynders M, Willems A, et al. Enteroviral infection of a cardiac prosthetic device[J]. Clin Infect Dis, 2011, 52(6): 710–716. DOI:  10.1093/cid/ciq189.
    [17] Waggoner JJ, Abeynayake J, Sahoo MK, et al. Development of an internally controlled real-time reverse transcriptase PCR assay for pan-dengue virus detection and comparison of four molecular dengue virus detection assays[J]. J Clin Microbiol, 2013, 51(7): 2172–2181. DOI: 10.1128/JCM.00548−13.
    [18] Ishiko H, Shimada Y, Konno T, et al. Novel human adenovirus causing nosocomial epidemic keratoconjunctivitis[J]. J Clin Microbiol, 2008, 46(6): 2002–2008. DOI: 10.1128/JCM.01835−07.
    [19] Jubinville E, Veillette M, Milot J, et al. Exacerbation induces a microbiota shift in sputa of COPD patients[J]. PLoS One, 2018, 13(3): e0194355. DOI:  10.1371/journal.pone.0194355.
    [20] Haldar K, Bafadhel M, Lau K, et al. Microbiome balance in sputum determined by PCR stratifies COPD exacerbations and shows potential for selective use of antibiotics[J]. PLoS One, 2017, 12(8): e0182833. DOI:  10.1371/journal.pone.0182833.
    [21] Zwaans WAR, Mallia P, Van Winden MEC, et al. The relevance of respiratory viral infections in the exacerbations of chronic obstructive pulmonary disease—a systematic review[J]. J Clin Virol, 2014, 61(2): 181–188. DOI:  10.1016/j.jcv.2014.06.025.
    [22] Xie LY, Zhang B, Xiao NG, et al. Epidemiology of human adenovirus infection in children hospitalized with lower respiratory tract infections in Hunan, China[J]. J Med Virol, 2019, 91(3): 392–400. DOI:  10.1002/jmv.25333.
    [23] Wang XY, Wang DW, Umar S, et al. Molecular typing of human adenoviruses among hospitalized patients with respiratory tract infections in a tertiary Hospital in Guangzhou, China between 2017 and 2019[J]. BMC Infect Dis, 2021, 21(1): 748. DOI: 10.1186/s12879−021−06412−0.
    [24] Seemungal T, Harper-Owen R, Bhowmik A, et al. Respiratory viruses, symptoms, and inflammatory markers in acute exacerbations and stable chronic obstructive pulmonary disease[J]. Am J Respir Crit Care Med, 2001, 164(9): 1618–1623. DOI:  10.1164/ajrccm.164.9.2105011.
    [25] Rohde G, Wiethege A, Borg I, et al. Respiratory viruses in exacerbations of chronic obstructive pulmonary disease requiring hospitalisation: a case-control study[J]. Thorax, 2003, 58(1): 37–42. DOI:  10.1136/thorax.58.1.37.
    [26] Papi A, Bellettato CM, Braccioni F, et al. Infections and airway inflammation in chronic obstructive pulmonary disease severe exacerbations[J]. Am J Respir Crit Care Med, 2006, 173(10): 1114–1121. DOI: 10.1164/rccm.200506−859OC.
    [27] Varkey JB, Varkey B. Viral infections in patients with chronic obstructive pulmonary disease[J]. Curr Opin Pulm Med, 2008, 14(2): 89–94. DOI:  10.1097/MCP.0b013e3282f4a99f.
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  • 收稿日期:  2021-12-23
  • 网络出版日期:  2022-04-14
  • 刊出日期:  2022-05-31

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