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国际流行病学传染病学杂志
国际流行病学传染病学杂志

毛江森

双月刊

1673-4149

gjlczz@sohu.com

0571-88215500

310013

浙江省杭州市天目山路182号

国际流行病学传染病学杂志/Journal International Journal of Epidemiology and Infectious Disease北大核心CSTPCD
查看更多>>1974年创刊，中华人民共和国卫生部主管，中华医学会、浙江省医学科学院主办。本刊是公开发行的国家级医学学术期刊，中国科技论文统计源期刊、中国科技核心期刊，国家首批允许刊登处方药广告的重点专业媒体。杂志栏目设有决策参考、专家论坛、论著、短篇论著、临床经验、病例报道、实验研究、综述、讲座及国际会议动态等。
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    百日咳诊疗方案（2023年版）

    1-3页
    查看更多>>摘要：百日咳（pertussis，whooping cough）是由百日咳鲍特菌（Bordetella pertussis）感染引起的急性呼吸道传染病。由于接种疫苗后产生的免疫力衰减和百日咳鲍特菌变异，全球很多疫苗覆盖率较高的国家出现了"百日咳再现"，发病年龄高峰从婴幼儿转移至青少年及成年人，青少年及成年人成为婴儿百日咳的主要传染源。百日咳是《中华人民共和国传染病防治法》规定的乙类传染病。为进一步规范百日咳的临床诊疗工作，结合国内外研究进展和诊疗经验，制定本诊疗方案。

    百日咳诊断治疗

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    水痘诊疗方案（2023年版）

    4-6页
    查看更多>>摘要：水痘（varicella, chickenpox）是由水痘-带状疱疹病毒（varicella-zoster virus，VZV）感染引起的一种呼吸道传染病，传染性强。以斑疹、丘疹、疱疹、结痂同时出现为特点。免疫功能低下者感染时可发展为重症，也可因潜伏的VZV再激活而引起带状疱疹。为进一步规范水痘临床诊疗工作，结合国内外研究进展和诊疗经验，制定本诊疗方案。

    水痘诊断治疗

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    新型冠状病毒抗原性变异和血清分型研究进展

    杜沛王奇慧
    7-11页
    查看更多>>摘要：当前，SARS-CoV-2各变异株之间交叉中和活性的下降提示出现不同的血清型。对病毒进行血清分型是多价/广谱疫苗研究的重要参考依据，也是疫情防控的重要指导。近日已有文献基于血清中和数据对SARS-CoV-2的抗原性分化和血清分型进行了研究和讨论。因此，本文对SARS-CoV-2血清分型的必要性、最新进展和重要价值进行综述。 The diminishing cross-neutralization activity among SARS-CoV-2 variants indicates that distinct serotypes of SARS-CoV-2 have emerged. Understanding the viral serotypes is crucial for the development of multivalent/broad-spectrum vaccines and serves as a pivotal guide for epidemic prevention and control. Recent literatures have discussed the antigenic differentiation and serotyping of SARS-CoV-2 based on serum neutralization data. Therefore, this review aims to provide an overview of the necessity, recent advances and the significance of SARS-CoV-2 serotype classification.

    新型冠状病毒血清分型多价/广谱疫苗疫情防控抗原分化

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    新型冠状病毒奥密克戎毒株感染者初次感染及二次感染中和抗体的变化

    刘小霞遆亚楠张缭云王晓燕...
    12-17页
    查看更多>>摘要：目的 探讨初次及二次感染SARS-CoV-2奥密克戎毒株感染者血清中和抗体（neutralizing antibodies, NAbs）水平变化。 方法 采取整群随机抽样方法，抽取山西医科大学第一医院2022年12月至2023年1月SARS-CoV-2核酸或抗原检测为阳性、临床分型为轻型及中型的122例医务人员为研究对象，观察血清NAbs水平变化并探讨NAbs与2023年5月是否二次感染的相关性。采用胶体金免疫层析法逐月检测其血清NAbs级别，由胶体金免疫层析分析仪转化为定量结果。 结果 122例患者初次感染SARS-CoV-2后NAbs均转为阳性，且NAbs水平于初次感染后2个月时浓度最高，后随感染时间的延长而降低；二次感染者58例（47.54%, 58/122），未感染者64例（52.46%, 64/122）。二次感染组二次感染前NAbs为3级和2级的人数分别为3例和24例，均少于未感染组，差异有统计学意义（χ2=8.26, P=0.015）；二次感染后NAbs为3级的人数为9例，多于未感染组，差异有统计学意义（χ2=8.23, P=0.017）。 结论 健康人群感染SARS-CoV-2后均可产生NAbs，其水平以感染后2个月较高，峰值持续1~2个月后逐渐降低。NAbs水平降至一定程度后可二次感染，二次感染后NAbs水平再次增高。推测高水平NAbs有一定的保护性，监测人群NAbs水平可预测SARS-CoV-2流行态势。 Objective To investigate the changes of serum neutralizing antibodies (NAbs) levels in patients with primary and secondary infection of SARS-CoV-2 Omicron variant. Methods A cluster random sampling method was used to select 122 medical staff with positive SARS-CoV-2 nucleic acid or antigen detection and clinical classification of mild and moderate in the First Hospital of Shanxi Medical University from December 2022 to January 2023 as the research objects. The changes in serum NAbs levels were observed and the correlation between NAbs and secondary infection in May 2023 was discussed. The serum NAbs levels were detected monthly by colloidal gold immunochromatography, and the quantitative results were obtained by colloidal gold immunochromatography analyzer. Results The NAbs in 122 patients turned out to be positive after the primary infection of SARS-CoV-2, and the level of NAbs was the highest after 2 months of the primary infection, and then decreased over time. Among these patients, 58 cases (47.54%, 58/122) had secondary infections, while 64 cases (52.46%, 64/122) were not infected. The numbers of patients with NAbs of grade 3 and grade 2 before the secondary infection in the secondary infection group were 3 and 24 cases, respectively, which were lower than those in the non-infection group, and the difference was statistically significant ( χ2=8.26, P=0.015). The number of patients with NAbs of grade 3 after the secondary infection was 9 cases, which was higher than that in the non-infection group, and the difference was statistically significant ( χ2=8.23, P=0.017). Conclusions NAbs can be produced in healthy individuals after infection with SARS-CoV-2, and the level is the highest after 2 months of infection, with a peak lasting for 1-2 months before gradually decreasing. After the level of NAbs decreases to a certain level, it could lead to a secondary infection and the level of NAbs increases again. It is speculated that the high level of NAbs has a certain degree of protection. Monitoring the level of NAbs in the population can predict the epidemic trend of SARS-CoV-2.

    新型冠状病毒奥密克戎毒株中和抗体二次感染监测

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    重庆市新型冠状病毒二次感染者流行病学特征分析

    赵寒漆莉熊宇杨琳...
    18-22页
    查看更多>>摘要：目的 了解重庆市SARS-CoV-2二次感染者的流行病学及临床特征，为优化COVID-19防控策略提供参考依据。 方法 选取2020年1月至2022年10月国家传染病监测报告管理系统中重庆市报告的2 416例SARS-CoV-2感染者作为调查对象，并通过现场或电话调查他们在2022年11月至2023年1月期间的二次感染状况，内容包括人口学特征、SARS-CoV-2核酸检测结果、抗原检测结果、第二次感染相关症状及诊疗信息、疫苗接种相关信息等，通过重庆市病原体检测系统查询核酸检测信息，通过重庆市免疫规划信息管理系统查询疫苗接种信息，统计分析二次感染率和临床特征。 结果 共1 971例既往SARS-CoV-2感染者接受调查，接受率81.58%（1 971/2 416）。明确二次感染率9.22%（181/1 964），粗略二次感染率20.40%(402/1 971)。奥密克戎变异株、德尔塔变异株和原始毒株既往感染者二次感染率差异有统计学意义（χ 2=481.163，P<0.001）；96.02%（386/402）的二次感染者出现症状，15.96%（64/402）的二次感染者入院诊疗，1.49%（6/402）的二次感染者住院治疗，无重症死亡；咳嗽（59.33%，229/386）和发热（54.15%，209/386）为主要症状；与第一次感染间隔时间在1年及以上（12~<24个月：OR=9.879，95%CI: 4.822~20.244；≥24个月：OR=17.489，95%CI: 12.708~24.070）、20~<60岁（OR=2.860，95%CI: 1.742~4.697）为发生粗略二次感染的危险因素，接种2剂次以上疫苗（2剂：OR=0.468,95%CI：0.220~0.997；3剂：OR=0.414,95%CI：0.210~0.815；4剂：OR=0.142,95%CI：0.038~0.534）为保护性因素。 结论 重庆市不同特征人群的SARS-CoV-2二次感染率差异较大，年龄和职业的感染差异显示与社会活跃度和积极保护措施有关，造成二次感染发生的主要原因是SARS-CoV-2变异毒株的突破性和感染间隔时间。SARS-CoV-2在不断变异过程中发生的重复感染的风险还存在多变性，应持续开展相关监测。 Objective To understand the epidemiological and clinical characteristics of patients with secondary infection of SARS-CoV-2, and to provide reference for optimizing the strategy of prevention and control of COVID-19. Methods A total of 2 416 COVID-19 cases reported in Chongqing from January 2020 to October 2022 were selected as the study subjects. Field or telephone surveys were conducted on their secondary infection status from November 2022 to January 2023, including demographic characteristics, results of nucleic acid testing, antigen testing results, symptoms and diagnosis information related to the second infection, vaccine-related information, etc. The nucleic acid testing information was obtained from Chongqing pathogen detection system, and vaccination information was obtained from the immunization program information management system of Chongqing. The prevalence of secondary infection and clinical characteristics were statistically analyzed. Results A total of 1 971 prior COVID-19 individuals were investigated, with a response rate of 81.58% (1 971/2 416). The confirmed secondary infection rate was 9.22% (181/1 964), and the crude rate was 20.40% (402/1 971). There was a statistically significant difference in the secondary infection rates among individuals previously infected with Omicron variant, Delta variant, and original strain ( χ2=481.163, P<0.001). Among the secondary infection cases, 96.02% (386/402) presented symptoms,15.96% (64/402) were admitted to hospital, 1.49% (6/402) were hospitalized with no severe cases or deaths. The main symptoms were cough (59.33%, 229/386) and fever (54.15%, 209/386). An interval of 1 year or longer since the first infection (12-<24 months:OR=9.879, 95%CI: 4.822-20.244 ≥24 months: OR=17.489, 95%CI: 12.708-24.070) and age between 20 and 60 years (OR=2.860, 95%CI: 1.742-4.697) were risk factors for secondary infection, while two or more doses of vaccine (2 doses: OR=0.468, 95%CI: 0.220-0.997 3 doses: OR=0.414, 95%CI: 0.210-0.815 4 doses: OR=0.142, 95%CI: 0.038-0.534) was a protective factor. Conclusions There is a significant difference in the rate of SARS-CoV-2 secondary infection among different population groups in Chongqing. Differences in infection based on age and occupation are related to social activity and active protection measures. Breakthrough infections caused by SARS-CoV-2 variant strains and long interval between infections are identified as the main reasons for secondary infection. The risk of repeat infections remains variable during the continuous evolution of SARS-CoV-2, and COVID-19 monitoring should be continued.

    新型冠状病毒感染奥密克戎变异株二次感染流行病学特征

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    云南省临沧市新型冠状病毒奥密克戎变异株BN.1的全基因组特征和进化分析（2022年）

    张井巍易彬丁湘贵宋子龙...
    23-27页
    查看更多>>摘要：目的 了解2022年云南省临沧市8例SARS-CoV-2感染者的病毒全基因组测序结果及进化情况。 方法 2022年10月30日至11月4日采集临沧市8例SARS-CoV-2感染者的鼻咽拭子样本进行MiniSeq illumina二代测序获得病毒的全基因组序列。应用在线分析平台判断病毒的类型，利用分子进化遗传分析软件鉴别基因的变异位点，与参考基因组进行比对，构建生物进化树。 结果 8份样本ORF1ab基因的Ct值为19.16~23.64，N基因为16.71~24.08。全基因组序列显示，基因测序准确度Q30为90.1%（>80%），簇密度为256 K/mm2。与武汉参考株（GenBank登录号：MN908947.3）序列比较，共检测出1份95处核苷酸突变位点，6份94处核苷酸突变位点，1份93处核苷酸突变位点。病毒分型结果显示，所有样本均属于奥密克戎变异株BN.1进化分支。进化分析结果显示，8份样本差异数小于3，属于同一条传播链。 结论 此次疫情病例为同一传染源，首例病例发病前有边境地区（缅甸）活动史，再结合云南省发生BN.1变异株疫情的地区均处于与缅甸交接处和基因测序结果等情况，综合分析本次疫情为境外（缅甸）输入新的病毒感染的可能性较大。 Objective To investigate the whole genome sequencing and evolutionary status of SARS-CoV-2 in 8 COVID-19 cases in Lincang City, Yunnan Province in 2022. Methods Nasal and throat swab samples were collected from 8 patients with COVID-19 in Lincang City, Yunnan Province from October 30 to November 4, 2022 for MiniSeq Illumina second-generation sequencing to obtain the complete viral genome sequence. The types of viruses were determined by online analysis platform. The gene mutation sites were identified using molecular evolutionary genetics analysis software, and a reference genome was compared to build a biological evolutionary tree. Results In 8 samples, the Ct values of the ORF1ab gene were ranged from 19.16 to 23.64, and those of N gene were ranged from 16.71 to 24.08. The whole genome sequence showed that the accuracy of the gene sequencing Q30 was 90.1% (>80%), and the cluster density was 256 K/mm2. Compared with the sequence of the Wuhan reference strain (GenBank registration number: MN908947.3), 1 sample had 95 nucleotide mutation sites, 6 samples had 94 nucleotide mutation sites, and 1 sample had 93 nucleotide mutation sites. The virus typing results indicated that it belonged to the Omicron variant BN.1 evolutionary branch. Evolutionary analysis showed that the differences among 8 samples were less than 3, indicating that they belonged to the same transmission chain. Conclusions The epidemic in Lincang City is from the same source of infection. The first case had a history of activity in border areas (Myanmar) before the onset. Combined with the occurrence of the variant BN.1 branch epidemic in Yunnan Province where locates at the border with Myanmar, and the gene sequencing results, it is highly probable that this epidemic is caused by a new virus imported from abroad (Myanmar).

    新型冠状病毒全基因组测序Omicron变异株（BN.1进化分支）进化分析

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    新型冠状病毒感染患者血清和肺泡灌洗液中白细胞介素6的动态变化及临床意义

    袁灵敏李群黄燕
    28-32页
    查看更多>>摘要：目的 探讨COVID-19患者血清和肺泡灌洗液（bronchoalveolar lavage fluid，BALF）中IL-6的动态变化及与临床预后关系。 方法 选取2020年1月至2023年5月龙游县人民医院重症医学科收治的48例COVID-19患者作为试验组，并选取同时间段45例非COVID-19病毒性肺炎患者作为对照组，分别监测两组患者血清和BALF中的IL-6水平。根据临床预后情况将试验组分为好转组（26例）和恶化组（22例），分析两组患者血清和BALF中IL-6的变化，并在病程第10天计算临床肺部感染评分（CPIS），分析IL-6与CPIS的相关性。 结果 试验组患者血清和BALF中IL-6水平分别为(24.90 ± 7.56) pg/mL和(79.46 ± 23.81) pg/mL，均高于对照组的(3.60±1.36 ) pg/mL和（28.29±10.87） pg/mL，差异有统计学意义（t =19.203和13.466，P均< 0.001）。COVID-19患者组内比较，好转组患者血清和BALF中IL-6水平分别为（22.73± 5.72） pg/mL和（72.58 ± 18.23） pg/mL，均低于恶化组[（27.45 ± 8.72） pg/mL和(87.59 ± 27.31) pg/mL]，差异有统计学意义（t = -2.175和-2.198，P = 0.029和0.028）。相关性分析结果显示，IL-6水平与COVID-19患者的CPIS呈显著正相关（r=0.760~0.905, P < 0.001）。 结论 IL-6能反映COVID-19的严重程度，且与患者的预后密切相关，IL-6水平越高提示预后越差。 Objective To explore the dynamic changes of IL-6 in serum and bronchoalveolar lavage fluid (BALF) of patients with COVID-19 and its correlation with clinical prognosis. Methods From January 2020 to May 2023, 48 COVID-19 patients admitted to intensive care unit of Longyou County People's Hospital were selected as the experimental group, and 45 patients with non-COVID-19 viral pneumonia in the same period were selected as the control group. IL-6 levels in serum and BALF were detected in both groups. According to clinical prognosis, the experimental group was divided into the improved group (26 cases) and the deteriorated group (22 cases), and the changes of IL-6 in serum and BALF of the two groups were analyzed. On the 10th day of illness, the clinical pulmonary infection score (CPIS) was calculated, and its correlation with IL-6 was analyzed. Results The levels of IL-6 in the serum and BALF in the experimental group were (24.90±7.56) pg/mL and (79.46±23.81) pg/mL, respectively, which were significantly higher than those in the control group [(3.60±1.36) pg/mL and (28.29±10.87) pg/mL](t=19.203 and 13.466, P < 0.001). Among COVID-19 patients, the IL-6 levels in serum and BALF in the improved group were (22.73± 5.72) pg/mL and (72.58 ± 18.23) pg/mL, respectively, which were significantly lower than those in the deterioratd group [(27.45±8.72) pg/mL and (87.59±27.31) pg/mL]( t=-2.175 and -2.198, P=0.029 and 0.028). Correlation analysis revealed a significant positive correlation between IL-6 levels and CPIS of COVID-19 patients (r=0.760-0.905, P<0.001). Conclusions The level of IL-6 can reflect the severity of COVID-19 and is closely related to the patient's prognosis. Higher levels of IL-6 indicate a poorer prognosis.

    新型冠状病毒感染白细胞介素6肺泡灌洗液预后相关性

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    重庆市新型冠状病毒感染疫情流行病学特征及其参数与防控措施评估（2020年）

    罗庆龙江熊宇王开发...
    33-37页
    查看更多>>摘要：目的 了解重庆市2020年度SARS-CoV-2感染者流行病学特征，并估计该阶段疫情传播的重要流行病学参数，探究防控措施对新发流行病传播的影响。 方法 回顾性收集重庆市卫生健康委员会和重庆市疾病预防控制中心2020年重庆市SARS-CoV-2感染者的数据，采用描述性统计分析方法，对疾病进行流行病学特征分析，构造似然函数，并根据Akaike信息准则估计了潜伏期的最优概率分布。最后基于极大似然思想和贝叶斯框架对基本再生数、有效再生数进行了估计。 结果 重庆市于2020年1月1日出现首例病例，发病高峰在1月24—26日，2月21日之后无新发病例。渝东北片区地区发病率最高（3.28/10万）。发病人群男女性别比为1.10∶1，总体发病率男性（1.86 /10万）稍高于女性（1.73 /10万）。确诊病例中占比最多的年龄组为45~50岁（91例，91/576），其次是50~55岁（71例，71/576）。潜伏期的最优概率分布为伽马分布，估计均值为7.22 d。重庆市COVID-19疫情初始阶段的基本再生数估计为2.68（2.04, 3.44），有效再生数的变化趋势与防控策略的实施密切相关。 结论 重庆市2020年1—2月全市COVID-19流行曲线呈起病急、收尾快的特点。尽管疫情具有较强的传播性，但定量和定性分析均表明政府采取防控措施及时有效，为将来新发突发传染病防控积累了经验。 Objective To understand the epidemiological characteristics of COVID-19 cases in Chongqing in 2020, and to estimate the important epidemiological parameters of epidemic transmission at that stage, so as to explore the impact of prevention and control measures on the spread of emerging epidemics. Methods Based on the retrospective data of COVID-19 cases in Chongqing in 2020 from Chongqing Municipal Health Commission and Chongqing Municipal Center for Disease Control and Prevention, descriptive statistical analysis method was used to analyze the epidemiological characteristics of the disease. Then, the likelihood function was constructed and the optimal probability distribution of the incubation period was estimated according to the Akaike information criterion. The basic reproduction number and effective reproduction number were estimated based on the maximum likelihood principle and Bayesian framework. Results The first case of COVID-19 in Chongqing appeared on January 1, 2020, with the peak of infection from January 24 to January 26. After February 21, no new cases were reported. The highest incidence rate was observed in the northeastern region of Chongqing (3.28 per 100 000). The male-to-female ratio was 1.10:1. The overall incidence rate among males (1.86 per 100 000) was slightly higher than that among females (1.73 per 100 000). The age group with the highest proportion of confirmed cases was 45-50 years old (91 cases, 91/576), followed by the 50-55 age group (71 cases, 71/576). The optimal probability distribution in the incubation period was gamma distribution, with an estimated average of 7.22 days. The estimated basic reproduction number in the early stage of COVID-19 epidemic in Chongqing was 2.68 (2.04, 3.44), and the trend of effective reproduction number was closely related to the implementation of prevention and control strategies. Conclusions The COVID-19 epidemic in Chongqing from January to February 2020 exhibited a rapid onset and quick decline. Despite its high transmissibility, both quantitative and qualitative analyses indicate that the government's timely and effective implementation of prevention and control measures has accumulated experience for new outbreaks of infectious diseases in the future.

    新型冠状病毒感染潜伏期基本再生数有效再生数防控措施

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    脑脊液B细胞趋化因子配体13在神经梅毒诊断中的临床意义

    殷晓云胥萍陈慧吴敏智...
    38-42页
    查看更多>>摘要：目的 了解梅毒患者脑脊液（CSF）B细胞趋化因子配体13（CXCL13）在神经梅毒诊断中的临床价值。 方法 以2018年10月至2022年12月苏州市第五人民医院收治住院的208例梅毒患者为研究对象，其中确诊神经梅毒患者116例与非神经梅毒92例，收集人口统计学和疾病史等临床特征资料。采用ELISA法测CSF中趋化因子CXCL13的表达水平，并评价其诊断效能。 结果 神经梅毒组CSF-CXCL13水平为93.91(28.05,412.65) pg/mL，高于非神经梅毒组的5.41(3.86,25.45) pg/mL，差异有统计学意义（U=9 366.51，P<0.001）。与CSF-CXCL13表达水平<5.43 pg/mL者相比，CSF-CXCL13在5.43~31.49 pg/mL、31.50~121.44 pg/mL、和≥121.45 pg/mL的梅毒患者发生神经梅毒的风险分别增加11.14、22.74和659.40倍。ROC曲线分析显示，CSF-CXCL13诊断神经梅毒的曲线下面积达到0.89，CSF-WBC、CSF-蛋白与CSF-CXCL13联合检测诊断神经梅毒的AUC为0.93，其灵敏度为83.37%，特异性为91.42%。 结论 CSF-CXCL13表达水平升高是梅毒患者发生神经梅毒风险的预测因子，对神经梅毒的早期诊断有一定参考价值。 Objective To investigate the clinical value of cerebrospinal fluid (CSF) B-cell chemokine ligand 13 (CXCL13) in the diagnosis of neurosyphilis in patients with syphilis. Methods A total of 208 syphilis patients admitted to Suzhou Fifth People's Hospital from October 2018 to December 2022 were enrolled in this study. Among them, 116 cases were confirmed with neurosyphilis and 92 cases with non-neurosyphilis, and their demographic and clinical features were collected. The expression levels of CXCL13 in CSF were measured using enzyme-linked immunosorbent assay (ELISA), and its diagnostic value was evaluated. Results The level of CSF-CXCL13 in neurosyphilis group was 93.91(28.05, 412.65) pg/mL, which was higher than that of 5.41 (3.86, 25.45) pg/mL in the non-neurosyphilis group, with a statistically significant difference (U=9 366.51, P<0.001). Compared with patients with the level of CSF-CXCL13<5.43 pg/mL, the risk of developing neurosyphilis in patients with CSF-CXCL13 levels in the ranges of 5.43-31.49 pg/mL, 31.50-121.44 pg/mL, and ≥121.45 pg/mL increased by 11.14 times, 22.74 times, and 659.40 times, respectively. ROC analysis showed that the area under ROC curve (AUC) of CSF-CXCL13 in diagnosing neurosyphilis reached 0.89, and the AUC of combined detection of CSF-WBC, CSF-Pro, and CSF-CXCL13 in diagnosing neurosyphilis was 0.93, with a sensitivity of 83.37% and a specificity of 91.42%. Conclusions Elevated expression levels of CSF-CXCL13 are predictive factors for the risk of neurosyphilis in syphilis patients, providing a certain reference value for the early diagnosis of neurosyphilis.

    神经梅毒趋化因子CXCL13脑脊液蛋白联合检测预测

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    白细胞介素22及其受体1基因多态性与海南汉族人群支气管哮喘易感性的关系

    钟培雄陈钰郝金香吴挺实...
    43-48页
    查看更多>>摘要：目的 探讨IL-22及其受体1基因多态性与海南汉族人群支气管哮喘易感性的关系。 方法 选取2019年1月至2022年10月海口市第三人民医院收治的135例哮喘患者作为哮喘组，正常者85例作为对照组。比较两组人群血清IL-22、IL-22受体1和IgE水平，分析IL-22和IL-22受体1基因各位点的基因型和等位基因频率分布情况。应用Logistic回归分析IL-22和IL-22受体1基因多态性与海南汉族人群哮喘发病的关系。 结果 哮喘组血清IL-22[（61.37±12.40） pg/mL vs（26.25±8.72） pg/mL]、IL-22受体1[（46.28±10.51） pg/mL vs（14.50±4.63） pg/mL]及IgE[（304.72±116.37） IU/mL vs（59.36±9.80） IU/mL]水平均明显高于对照组（t=16.22、18.60和12.41，均P<0.001）。哮喘组rs2227485位点GG（42.2%vs 20.0%)、GA基因型（34.1% vs 63.5%），rs1179251位点CC（61.5% vs 41.2%）、CT基因型（29.6% vs 50.6%）和rs3795299位点CC（57.0% vs 41.2%）、CG基因型（30.4% vs 45.9%）分布频率与对照组比较，差异均有统计学意义（χ 2=11.54、8.65和5.42，P=0.001、0.003和0.020）。rs2227485位点GA基因型、rs1179251位点CT基因型、rs3795299位点CG基因型患者的血清IL-22水平[（42.58±9.37） pg/mL、（77.25±22.36） pg/mL和（68.12±15.48） pg/mL]，IL-22受体1水平[（31.15±7.20） pg/mL、（57.14±17.20） pg/mL和（52.36±15.28） pg/mL]及IgE[（125.73±50.36） IU/mL、（412.37±185.62） IU/mL和（381.26±151.20） IU/mL）]水平明显低于其他基因型（F=15.71、13.93、16.81、14.61、11.85、17.23、14.99、15.11和13.92，均P<0.001）。Logistic回归分析显示，rs2227485位点GA基因型（OR=0.893，95%CI：0.712～0.954）、rs1179251位点CT基因型（OR=0.794，95%CI：0.591～0.826）及rs3795299位点CG基因型（OR=0.840，95%CI：0.668～0.913）与哮喘发病风险降低有关。 结论 IL-22及IL-22受体1基因多态性可能与海南汉族人群哮喘易感性有关，其中GA、CT和CG基因型能够降低哮喘发病风险。 Objective To investigate the relationship between interleukin-22 (IL-22) and IL-22 receptor 1 (IL-22R1) gene polymorphisms and the susceptibility to bronchial asthma in Hainan Han population. Methods A total of 135 patients with asthma in the Third People's Hospital of Haikou from January 2019 to October 2022 were selected as asthma group, and 85 normal individuals were selected as the control group. The serum levels of IL-22, IL-22R1 and IgE were compared between the two groups, and the genotype and allele frequency distribution of IL-22 and IL-22R1 genes were analyzed. Logistic regression analysis was used to determine the relationship between IL-22 and IL-22R1 gene polymorphisms and the incidence of asthma in Hainan Han population. Results The levels of serum IL-22[(61.37±12.40) pg/mL vs (26.25±8.72) pg/mL], IL-22R1[ (46.28±10.51) pg/mL vs (14.50±4.63) pg/mL] and IgE[ (304.72±116.37) IU/mL vs(59.36±9.80) IU/mL] in asthma group were significantly higher than those in the control group(t=16.22, 18.60 and 12.41, all P<0.001). The distribution frequencies of GG (42.2%vs 20.0%) and GA genotype (34.1% vs 63.5%) at rs2227485, CC (61.5% vs 41.2%) and CT genotype (29.6% vs 50.6%) at rs1179251, and CC (57.0% vs 41.2%) and CG genotype (30.4% vs 45.9%) at rs3795299 in asthma group were significantly different from those in the control group (χ 2=11.54, 8.65 and 5.42, P=0.001, 0.003 and 0.020). The levels of serum IL-22[ (42.58±9.37) pg/mL, (77.25±22.36) pg/mL and (68.12±15.48) pg/mL], IL-22R1[ (31.15±7.20) pg/mL, (57.14±17.20) pg/mL and (52.36±15.28) pg/mL] and IgE [ (125.73±50.36) IU/mL, (412.37±185.62) IU/mL and (381.26±151.20) IU/mL] in the GA genotype at rs2227485, CT genotype at rs1179251 and CG genotype at rs3795299 were significantly lower than those in other genotypes (F=15.71, 13.93, 16.81, 14.61, 11.85, 17.23, 14.99, 15.11 and 13.92, all P<0.001). Logistic regression analysis showed that the GA genotype of rs2227485 (OR=0.893, 95%CI: 0.712-0.954), the CT genotype of rs1179251 (OR=0.794, 95%CI: 0.591-0.826) and the CG genotype of rs3795299 (OR=0.840, 95%CI: 0.668-0.913) were associated with the reduced risk of asthma. Conclusions Il-22 and IL-22R1 gene polymorphisms may be associated with the susceptibility to asthma in Hainan Han population, and their GA, CT and CG genotypes can reduce the risk of asthma.

    哮喘白细胞介素-22白细胞介素-22受体1基因多态性易感性

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