摘要目的 了解2005年至2011年青岛地区甲型流行性感冒病毒的药物敏感性,并探讨病毒耐药的分子机制.方法 采用化学发光法检测甲型流行性感冒病毒对神经氨酸酶抑制剂(NAI)奥司他韦的敏感性;分析病毒基质蛋白2(M2)基因序列以检测其对烷胺类药物的敏感性.应用MEGA 5.0软件进行基因组进化分析.结果 2005年至2011年青岛地区流行的HSN2亚型、新H1N1亚型流行性感冒病毒均未发现对奥司他韦耐药,但对烷胺类药物全部耐药;季节性H1N1流行性感冒病毒奥司他韦耐药株的比例由2008年至2009年流行季的28.6％(6/21)上升至2009年至2010年流行季的2/4,仅2008年至2009年流行季的28.6％ (6/21)毒株对烷胺类药物敏感;奥司他韦耐药株均为重配突变株.结论 基因组重配参与病毒NAI耐药性;奥司他韦应作为流行性感冒预防与治疗的首选药物,而流行性感冒病毒耐药性监测需进一步加强.

abstractsObjective To determine the drug sensitivity of influenza A viruses in Qingdao during the period form 2005 to 2011,and to illuminate the molecular mechanism contributing to virus drug resistance.Methods Chemiluminescence analysis was performed to detect the virus neuraminidase inhibitor susceptibility,and adamantane susceptibility was determined by sequence analysis of M2 gene.Phylogenetic analysis was conducted using MEGA 5.0 software.Results Both the H3N2 and pandemic H1N1 viruses circulated in Qingdao from 2005 to 2011 were susceptible to oseltamivir,but resistant to adamantine.The proportion of oseltamivir-resistant seasonal H1N1 influenza viruses was 28.6％ (6/21)between 2008 and 2009 and rose to 2/4 between 2009 and 2010,while all were resistant to adamantine except 28.6％ (6/21) of the viruses isolated between 2008 and 2009.All oseltamivir-resistant viruses underwent genome recombinants.Conclusions Genome recombinant events contribute to the emergence of drug resistance of influenza viruses and oseltamivir is the first choice in influenza prevention and treatment.The continuous surveillance of antiviral drug sensitivity of influenza viruses should be enhanced.