摘要
目的针对2008-2010年湖南省哨点医院手足口病实验室检测结果及其基因特征进行分析,为湖南省手足口病的综合防治提供参考资料。方法收集湖南省哨点医院2008-2010年手足口病病例送检的咽拭子、粪便等标本,用RD、Hep-2细胞对标本进行病毒分离,应用RT-PCR及Real ti me-PCR技术检测原始样本和分离阳性毒株中的肠道病毒71型（EV71）、柯萨奇病毒A组16型（CVA16）、非EV71和CVA16的其它肠道病毒（EV）,将分离到的EV71采用RT-PCR方法进行VP1编码区基因扩增,并对扩增产物进行序列测定和分析。结果 2008-2010年湖南省哨点医院HFMD患者2 448例的各类标本中检测到EV71病毒阳性1 228份,CVA16病毒阳性169份,EV71和CVA16病毒核酸同时阳性12份,非EV71和CVA16的其它肠道病毒（以下简称为EV）阳性518份,病原谱构成以EV71型为主,其构成比为63.73%（1 228/1 927）,其次EV占26.88%（518/1 927）、CVA16占8.77%（169/1 927）、EV71＋CVA16混合感染占0.62%。三种不同型别肠道病毒在每月中均有报告,EV71为优势病原体,4-7月达到峰值,其次为EV型,CVA16型每月维持在低水平的感染。HFMD病例人群男性高于女性（1.95：1）,1~3岁儿童是重症病例数及死亡病例数最多年龄段;湖南省14个地市（州）HFMD的病原谱均以EV71型为主。对845份阳性标本进行病毒分离,共获得肠道病毒211株,其中EV71型131株,CVA16病毒19株,非EV71和CVA16的其它EV型49株,混合感染12株。13株EV71 VP1编码区全长序列之间核苷酸同源性为97.35%~100%,氨基酸同源性为98.2%~100%,基因型为C4a亚型。结论 EV71型是2008-2010年湖南省手足口病流行的主要病原,也是引起手足口重症病例和死亡病例的主要毒株类型,属于C4a亚型。
Objective To understand the genetic information and pathogen characters of hand-foot-mouth disease（HFMD） in sentinel hospitals of Hunan from 2008 to 2010,and to provide the reference for laboratory diagnosis of HFMD in Hunan Province. Methods Specimens of HFMD cases were collected from the sentinel hospitals of Hunan Province from 2008 to 2010.Nucleic acids in three types,which were enterovirus viruses 71（EV71）,coxasckie virus A16（CVA16） and the enterovirus excluding EV71 and CVA16（EV）,were detected by RT-PCR and Realtime-PCR method.Totally 2,448 HFMD cases came from 14 districts/counties in sentinel hospitals of Hunan.The complete sequences of VP1 encoding region of several identified EV71 strains were determined and analyzed. Results Among the 2,448 samples of HFMD cases,the positive detectable rates of EV71,CVA16,EV71＋CVA16 and EV were 63%（1,228/1,927）,9%（169/1,927）,1%（12/1,927）,27%（518/1,927）,respectively.Three types of enterovirus were detected from January to December,and EV71 was the major enterovirus from April to July. The proportion of male and female in the cases of HFMD was 1.95：1.The most severe cases were dominated by the age group from one to three years.It was showed that all the 14 districts/counties had reported HFMD case and EV71 was the major pathogen.EV71 infection was mainly responsible for most of the severe and death cases.211 strains of positive viruses were obtained,including 131 strains of EV71,19 strains of CVA16,49 strains of EV,and 12 strains of mixed virus.EV71 strains of Hunan were clustered with representatives of subgenotype C4a and showed the highest identity to them,based on the sequence analyses of VP1 encoding region. Conclusions All the results indicated that EV71 was the major pathogens for the epidemic of HFMD in the sentinel hospitals of Hunan Province from 2008 to 2010.The circulating EV71 belonged to subgenotype C4a.
出处
《实用预防医学》
CAS
2011年第5期779-784,共6页
Practical Preventive Medicine
基金
国家科技重大专项资助项目(2009ZX10004-202)
