【摘要】 目的了解郴州市手足口病病原学及EV71型分离株基因特征。方法采集2012年郴州市手足口病临床诊断病例标本,应用荧光PCR方法检测EV71、CVA16和其他HEV;随机选择122份其他HEV阳性标本检测CVA6和CVA10;EV71阳性标本选用RD进行病毒分离,并进行VP1区核苷酸序列测定和分析。结果 2012年郴州市共检测手足口病标本1 158份,人肠道病毒阳性841份(阳性率为72.63%),其中EV71占61.71%,CVA16占8.32%,EV71和CVA16双阳性占0.24%,其他HEV阳性占29.73%。122份其他HEV阳性标本中,CVA6占33.61%;CVA10占6.56%。不同年龄、地区、月份和类型病例病原体型别构成比差异均有统计学意义。普通病例与重症(死亡)病例病原体型别构成比差异有统计学意义(χ2=47.11,P<0.01)。分离到7株EV71分离株,基因测序分析均为C4a亚型。结论 EV71是郴州市2012年手足口病流行的主要病原体。郴州市不同地区,或同一个地区的不同时间手足口病病原体的消长更替各地不一,呈现快速动态变化趋势。CVA6已成为除EV71和CVA16外,又一较为流行的病原体。更多还原

【Abstract】 Objective The study was conducted to understand the genetic characteristics of human enterovirus 71(EV71) and the pathogenic characters of hand-foot-mouth disease(HFMD) in Chenzhou Hunan in 2012, in order to provide references for laboratory diagnosis. Methods Clinical specimens of HFMD cases were collected from the sentinel hospitals of Chenzhou city in 2012. Nucleic acids of EV71, coxsackievirus A16(CA16) and other enterovirus were examined by fluorescent PCR. One hundred and twenty-two specimens that were positive for other HEV were randomly selected for CVA6 and CVA10 examination. EV71 positive samples were randomly selected for RD cell separation. VP1 fragment of EV71 isolations was amplified by RT-PCR for nucleotide sequencing and phylogenetic analysis. Results A total of 1158 clinical specimens collected from HFMD patients were analyzed, and 72.63% specimens were positive for HEV. Among the HEV positive samples, 61.71% was EV71, 8.32% was CVA16, 0.24% was EV71 and CVA16 double positive, and 29.76% was other HEV. Among the other HEV positive specimens, 33.61% was positive for CVA6 and 6.65% was positive for CVA10. Significant differences were found in the constituent ratios for month, age, region and patients manifestations. Gene sequencing of seven EV71 isolations illustrated that the genotypes were all subgenotype C4a. Conclusion In Chengzhou city in 2012, the predominant pathogen causing HFMD was EV71, which belonged to the C4a genotype. Pathogen type showed dynamic changing trend in different regions or one region in different time points. CVA6 was a new epidemic pathogen besides EV71 and CVA16 in Chenzhou city.更多还原