论文部分内容阅读
目的应用分子生物学方法检测和鉴定浙江省奉化市2010-2012年手足口病临床病例样本的肠道病毒,分析肠道病毒的流行特征。方法采集2010年3月～2012年7月浙江省奉化市人民医院收治的231例临床诊断为手足口病患者的咽拭子、血浆和粪便标本287份,采用巢式PCR方法进行肠道病毒的检测,对肠道病毒阳性的标本,应用测序方法根据5′UTR基因序列进行病毒分型并进行聚类分析。结果在231例临床诊断病例中,病原学诊断或者核酸检测阳性病例145例,其中男(88例)女(57例)性别比为1.54∶1。在287份临床样本中,肠道病毒阳性共167份,检出率为58.2%。145例病原学诊断或核酸检测阳性病例中,人肠道病毒71型(EV71)75例,占51.7%;柯萨奇病毒A组16型(CVA16)48例,占33.1%;其他型肠道病毒12例,占8.3%;有10份阳性病例无法鉴定分型,占6.9%。EV71型病例在2010-2011年较多,占成功分型病例的72.7%(64/88),而CVA16型在2012年较多,占72.3%(34/47)。聚类分析显示EV71毒株基因呈高相似性,与中国多地区已公布EV71序列非常接近,CVA16毒株聚为3小簇,而CVB3、CVA10等与已公布最接近序列仍有一定差异。结论奉化市2010-2012年手足口病以EV71及CVA16型为主,其中2010-2011年以EV71为主,2012年以CVA16为主,其他型如CVA4、CVA6、CVA10、CVA12、CVB3等也有发现。
Objective To detect and identify the enterovirus in clinical samples of HFMD in Fenghua City of Zhejiang Province from 2010 to 2012 by molecular biology method and analyze the epidemiological characteristics of enterovirus. Methods A total of 287 pharyngeal swabs, plasma and stool specimens of 231 clinically diagnosed HFMD patients were collected from March 2010 to July 2012 in Fenghuang People’s Hospital of Zhejiang Province. Nested PCR was performed on enterovirus Detection, positive samples of enteroviruses, sequencing methods based on 5’UTR gene sequence for virus typing and cluster analysis. Results Of the 231 clinically diagnosed cases, 145 were positive for pathogenic diagnosis or nucleic acid testing, with a sex ratio of 1.54: 1 for male (88) and female (57). In 287 clinical samples, a total of 167 positive enterovirus, the detection rate was 58.2%. Of the 145 etiological or nucleic acid positive tests, 75 were human enterovirus 71 (EV71), accounting for 51.7%; 48 were Coxsackievirus A (type 16A), accounting for 33.1%; other types of intestinal Virus in 12 cases, accounting for 8.3%; 10 positive cases can not identify typing, accounting for 6.9%. The EV71 cases were more in 2010-2011, accounting for 72.7% (64/88) of the successful cases, while CVA16 was more in 2012, accounting for 72.3% (34/47). Cluster analysis showed that the gene of EV71 strain showed high similarity, which was very close to the published EV71 sequence in many regions of China. The CVA16 strain clustered into 3 clusters, while CVB3, CVA10 and other published sequences still had some differences. Conclusion Fenghuang City was mainly affected by EV71 and CVA16 from 2010 to 2012, with EV71 mainly from 2010 to 2011 and CVA16 mainly from 2012 to 2012. Other types such as CVA4, CVA6, CVA10, CVA12 and CVB3 were also found .