【摘要】 目的:对2010年北京市昌平区手足口病患者及其密切接触者进行肠道病毒病原体检测,分析肠道病毒血清型分布情况。方法:采集医疗机构临床诊断为手足口病患者及重症患者密切接触人群鼻咽拭子及粪便样本,提取病毒核酸,使用人肠道病毒通用引物、肠道病毒71型和柯萨奇病毒A16型特异性引物进行逆转录-聚合酶链式反应(RT-PCR),检测肠道病毒病原体及肠道病毒71型和柯萨奇病毒A16型分布。结果:共采集448份鼻咽拭子及粪便标本,肠道病毒总体检出率为41.74%(187/448),其中肠道病毒EV71型、CoxA16型和未分型肠道病毒阳性检出率分别为21.43%(96/448)、8.48%(38/448)和11.83%(53/448)。比较肠道病毒EV71型和CoxA16型检出率的差异有统计学意义(μ=5.56,μ0.05=1.96,P<0.05)。448份标本中有59份粪便标本,肠道病毒EV71型、CoxA16型和未分型的检出率分别为37.29%(22/59)、3.39%(2/59)和3.39%(2/59)。389份鼻咽拭子标本中肠道病毒EV71型、CoxA16型和未分型的检出率分别为19.02%(74/389)、9.25%(36/389)和13.11%(51/389),比较鼻咽拭子和粪便标本中肠道病毒检出率的差异无统计学意义(μ=0.905,μ0.05=1.96,P>0.05)。临床诊断病例384例,采集鼻咽拭子标本384份,肠道病毒EV71型和CoxA16型检出率分别为17.97%(69/384)和9.90%(38/384)。71例重症病例中采集到标本的病例密切接触者53名,采集标本64份,肠道病毒EV71型和CoxA16型检出率分别为42.19%(27/64)和10.94%(7/64)。比较患者与密切接触者肠道病毒EV71型检出率的差异有统计学意义(2χ=16.02,20χ.05=3.84,P<0.05)。病例发病集中在5月-7月份,以EV71感染为主,病毒感染率以3岁组最高,集中在幼托儿童,男性病毒感染率高于女性。结论:引起北京市昌平区2010年手足口病流行的主要肠道病原体是肠道病毒71型,5岁以下男性儿童是易感人群,密切接触者标本检测到EV71型肠道病毒有助于病例诊断,粪便标本与鼻咽拭子的阳性检出率具有一致性。更多还原

【Abstract】 Objective:To detect enterovirus from the patients of Hand-foot-mouth Disease(HFMD) and their close contacts in Changping district of Beijing in 2010.And analysis the distribution of enterovirus 71(EV71 type) and Coxsackie virus A16(CoxA16 type).Methods: The specimens of nasopharyngeal swabs and fecal samples were collected,which from patients with Hand-foot-mouth Disease and the people in close contacts with patients.The viral RNA were extracted from collected specimens.Enterovirus were detected by reverse transcription-polymerase chain reaction(RT-PCR) using the universal primers of enterovirus.And then Enterovirus 71 and Coxsackie A16 were determined by RT-PCR with type-specific primers of enterovirus 71 and Coxsackie A16.Results: 448 samples were collected,The total enterovirus detection rate was 41.74%(187/448).The enterovirus EV71,CoxA16 and non-typeable enterovirus detection rates were 21.43%(96/448),8.48%(38/448) and 11.83%(53/448) respectively in 448 samples.The enterovirus EV71,CoxA16 and non-typeable enterovirus detection rates were 37.29%(22/59),3.39%(2/59) and 3.39%(2/59) respectively in 59 fecal samples.The enterovirus EV71,CoxA16 and non-typeable enterovirus detection rates were 19.02(74/389),9.25%(36/389) and 13.11%(51/389) respectively in 389 nasopharyngeal swabs samples.The enterovirus detection rate had no statistical significance between nasopharyngeal swabs and fecal samples.384 samples were collected from 384 cases.The enterovirus EV71 and CoxA16 detection rates were 17.97%(69/384) and 9.90%(38/384) respectively.64 specimens were collected from 53 close contacts of patients.The enterovirus EV71 and CoxA16 detection rates were 42.19%(27/64) and 10.94%(7/64) respectively.There was statistical significance between close contacts and patients(χ2 = 16.02,χ20.05 = 3.84,P<0.05).The cases mostly occupied in May to July.The incidence was the highest in 3 years old.They focused on kindergarten children.The incidence in male was higher than that of in female.Conclusion: The enterovirus 71 type was the leading cause of epidemic enterovirus for Hand-foot-mouth Disease in Changping district,Beijing in 2010.The second was CoxA16 type.The people under 5 years old are susceptible.It helped diagnosis for Hand-foot-mouth Disease to detect pathogens in close contacts with patients.The positive detection rate in fecal samples had no difference with that of nasopharyngeal swabs.更多还原