手足口病患儿EV71的检测与其临床分析  

Detection of Enterovirus 71 from Pediatric Patients with Hand-foot-and-mouth Disease and Clinical Analysis

作　　者：吴旭耀 沈彩燕 李成 沈伟伟[2] 王震[3] 

机构地区：[1]浙江省仙居县人民医院检验科,浙江仙居县317300 [2]台州市疾病预防控制中心,浙江台州318000 [3]温州医学院检验与生命科学学院,浙江温州325035

出　　处：《中华医院感染学杂志》2010年第24期3894-3896,共3页Chinese Journal of Nosocomiology

基　　金：仙居科技局资助项目(2008C04)

摘　　要：目的了解仙居县2008年6月-2009年6月儿童手足口病病例不同标本中肠道病毒EV71和CoxA16的感染情况,为手足口病的治疗和预防控制提供依据。方法采用逆转录聚合酶链反应(RT-PCR)及实时荧光RT-PCR方法,对145例疑似手足口病的咽拭子、疱疹液及脑脊液标本进行手足口致病病毒进行检测,全部取咽拭子145份,49份同时取疱疹液,47份同时取脑脊液,进行EV、EV7I和CoxA16的检测,最后对重症病例的病毒核酸测序,并进行基因分型。结果 145份疑似样品中,39份为肠道通用病毒阳性,其中21份样品EV71阳性,6份样品CoxA16阳性;咽拭子、疱疹液、脑脊液的检出率分别为28.6%、28.6%、12.8%;3例重症病例均只检出肠道病毒EV71,阳性率为100.0%。结论采用咽拭子及其疱疹液标本检出率比较,差异无统计学意义,且阳性检出率高于脑脊液标本,仙居县肠道病毒夏季高发,感染以EV71和CoxA16为主,手足口病重症感染病毒为EV71的C4亚型。OBJECTIVE To find out the state of the EV71 and CoxA16 infection in severe patients with hand-foot-and-mouth disease（HFMD） in Xianju from Jun 2008 to Dec 2009,in order to constitute the therapy,prevention and control strategy for HFMD in Xianju country.METHODS RT-PCR and real-time RT-PCR were taken to detect EV,EV71 and CoxA16 in 145 specimens,including 145 throat swabs,49 vesicle fluids and 47 cerebrospiral fluids.The amplification fragments were analyzed by DNA agarose gel electrophoresis.Enterovirus,EV71 and Cox A16 were detected,lastly,the product of VP1 gene was sequenced by the PCR to confirm EV 71 subtype.RESULTS The positive rates of EV71 from throat swabs,vesicle fluids and cerebrospiral fluids were 28.6%,28.6% and 12.8%,respectively.EV71 was identified from 3 severe patients（100.0%）.Among the 145 samples,39 samples were proved to be EV,21 samples to be EV71,6 samples to be CoxA16.CONCLUSION The positive rate of EV71 has no statistical difference between throat swabs and vesicle fluids.The summer and spring are the peak periods of prevalence of EV71 and CoxA16.The sequence analysis of vp1 gene of EV71 of severe patients shows that the popular subtype in Xianju is C4 subtype.

关 键 词：手足口病 肠道病毒71 柯萨奇病毒-16 逆转录聚合酶链反应 

分 类 号：R181.32[医药卫生—流行病学]