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目的首次实验室确诊1例先天性风疹综合征(congenital rubella syndrome,CRS)患者,为CRS的快速诊断和控制提供科学依据。方法采集患儿的血清、咽拭子和尿液标本,分别进行风疹IgM抗体检测和风疹病毒(RV)分离。应用逆转录PCR(RT-PCR)扩增RV分离株E1基因的945个核苷酸片段,并对扩增产物进行序列测定和分析。结果患儿的血清风疹IgM抗体阳性。从患儿的咽拭子和尿液中均分离出RV,通过比较核苷酸和氨基酸同源性及构建基因亲缘关系树,发现本例CRS的RV分离株属1E基因型,与1E基因型参考株(RVI MYS 01 1E)序列的核苷酸和氨基酸同源性分别为98.4%和99.6%。结论辽宁省首次通过实验室诊断方法对CRS临床符合病例进行确诊,并分离出1E基因型风疹病毒。
Objective To confirm the first laboratory diagnosis of congenital rubella syndrome (CRS) and provide a scientific basis for the rapid diagnosis and control of CRS. Methods Serum, throat swabs and urine samples were collected from children and were tested for rubella IgM antibody and rubella virus (RV) respectively. The 945-nucleotide fragment of the E1 gene of RV isolate was amplified by RT-PCR, and the amplified product was sequenced and analyzed. Results Serum rubella IgM antibodies were positive in children. RV was isolated from the throat swabs and urine of children. By comparing the nucleotide and amino acid homology and establishing the genetic relationship tree, we found that the RV isolates of CRS in this case belong to 1E genotype, The nucleotide and amino acid homologies of the reference strain (RVI MYS 01 1E) sequence were 98.4% and 99.6%, respectively. Conclusion The first case of CRS was confirmed by laboratory diagnosis in Liaoning Province and the 1E genotype was isolated.