摘要目的:分析苏州地区人群呼吸道样本中人偏肺病毒（human metapneumovirus，hMPV）的流行病学和基因组特征，为深入了解其遗传多样性和制定防控措施提供科学依据。方法:采集2024年苏州市两家哨点医院的1 340份流感样病例（influenza-like illness，ILI）和970份严重急性呼吸道感染（severe acute respiratory infection，SARI）患者的咽拭子样本，多重实时荧光PCR方法进行核酸检测。对hMPV阳性样本，使用Illumina Miseq二代测序平台进行全基因组测序。通过致病病毒全基因组分析系统识别突变、插入缺失等变异，并构建最大似然法进化树进行谱系分析。结果:在2 310份呼吸道标本中，hMPV总阳性率为1.69%（39/2 310），其中ILI组和SARI组的阳性率分别为1.27%（17/1 340）和2.27%（22/970），两者之间差异无统计学意义（ P>0.05）。hMPV阳性样本中，混合感染占比为46.15%（18/39），ILI组和SARI组的混合感染占比分别为23.53%（4/17）和63.64%（14/22）。时间分布上，hMPV感染的高峰期主要集中在1月和12月。成功获得13株hMPV毒株的全基因组，编码区发现554个错义突变，特别是在G基因区域变异显著。谱系分析显示，13株病毒株中，4株属于A2b2亚型，9株属于B2亚型。 结论:苏州地区hMPV在不同临床群体（ILI和SARI）中分布较为均衡，主要在冬季流行，且混合感染的比例较高。B2型为主要流行株，其基因组存在显著的遗传变异，特别是在G基因区域。

abstractsObjective:To analyze the epidemiological characteristics of human metapneumovirus（hMPV）in respiratory samples from patients in Suzhou，China，and investigate the results of whole-genome sequencing，so as to provide scientific evidence for a deeper understanding of its genetic diversity and the development of preventive measures.Methods:In this study，1 340 influenza-like illness（ILI）samples and 970 severe acute respiratory infection（SARI）samples were collected from two sentinel hospitals in Suzhou in 2024. Nucleic acid detection was performed using a multiplex real-time fluorescence PCR method. For hMPV-positive samples，whole-genome sequencing was conducted on the Illumina Miseq platform. Mutations，insertions，deletions，and other variations were identified using the pathogenic virus whole-genome analysis system. A phylogenetic tree was constructed by the Maximum Likelihood method for lineage analysis.Results:Among 2 310 respiratory samples，the overall hMPV positivity rate was 1.69%（39/2 310），with positivity rates of 1.27%（17/1 340）in ILI samples and 2.27%（22/970）in SARI samples. No statistically significant difference was observed between the two groups（ P>0.05）. The proportion of mixed infections in hMPV-positive samples was 46.15%（18/39），with mixed infection rates of 23.53%（4/17）in the ILI group and 63.64%（14/22）in the SARI group. In terms of temporal distribution，the peak period of hMPV infection primarily concentrated in January and December. The whole genomes of 13 hMPV strains were successfully obtained，and 554 missense mutations were identified in the coding region，with particularly significant variations observed in the G gene region. Phylogenetic analysis revealed that 4 strains belonged to the A2b2 subtype，while 9 strains belonged to the B2 subtype. Conclusions:In Suzhou，hMPV exhibits a relatively balanced distribution between ILI and SARI clinical groups，with infection peaks mainly occurring in winter and a high proportion of mixed infections. The predominant circulating strain is the B2 subtype，and its genome shows significant genetic variation，particularly in the G gene region.