2009年海南省手足口病样本病原学检测结果分析  

Analysis of pathogenic detection of hand-foot-mouth disease cases in Hainan Province in 2009

作　　者：马焱[1] 曾祥洁[1] 李丹丹[1] 陈海云[1] 潘正帆[1] 黄芳[1] 甘晓婷[1] 邱丽[1] 

机构地区：[1]海南省疾病预防控制中心,海南海口570203

出　　处：《中国热带医学》2011年第9期1064-1066,共3页China Tropical Medicine

基　　金：海南省自然科学基金项目(No.309073)

摘　　要：目的明确引起海南省2009年手足口病(Hand-foot-mouth disease,HFMD)暴发流行的主要病毒型别,为手足口病病例诊断和制定防控措施提供病原学依据。方法依据卫生部发布的《手足口病预防控制指南》(2009年版)附件1,提取手足口病临床诊断病例各种样本中的病毒核酸,用肠道病毒通用引物、肠道病毒71型(EV71)和柯萨奇病毒A16型(CoxA16)特异性引物进行逆转录-聚合酶链式反应(RT-PCR)和实时荧光-聚合酶链式反应(real-time PCR)。核酸检测阳性的原始样本接种人横纹肌肉瘤细胞(RD细胞)进行肠道病毒分离培养。结果海南省2009年各市县采集的1 085份手足口病样本中EV71、CoxA16和其它肠道病毒核酸阳性率分别为23.13%、1.57%和9.59%,不同类型病例的肠道病毒核酸阳性率分别为死亡病例55.56%(10/18),重症病例36.07%(145/402),普通病例32.63%(217/665)。不同类型样本肠道病毒核酸检测阳性率不同,肛拭子和粪便阳性率达到49.62%,疱疹液检测阳性率为43.84%,鼻咽拭子的检测阳性率为22.89%。结论引起海南省2009年手足口病暴发流行的主要病原是EV71,其次为CoxA16。应继续加强手足口病的病原学监测,掌握病毒型别变化趋势,更好地为手足口病防控工作提供技术支持。Objective To investigate the main virus type which caused pandemic of hand-foot-mouth disease（HFMD） in Hainan province in 2009.Methods According to the Ministry of Health issued＂Hand-foot-mouth disease control and prevention guide＂（2009） nucleic acids from HFMD specimens,such as nasal and throat swabs,anus swabs,herpes juice and so on extracted for clinical diagnosis of HFMD.The RNA was amplified by reverse transcription-polymerase chain reaction（RT-PCR） and real-time fluorescence PCR using the enterovirus universal primer,enterovirus type 71 primer and Coxsackie virus group A type 16 primer,as well as detecting products size.The nucleic acids positive specimens were inoculated to RD cell lines to isolate enteroviruses.Results The RNA positive rates of EV71,CoxA16 and other type EV were respectively 23.13%,1.57% and 9.59% in 1 085 specimens of HFMD in 2009.The positive rates of death cases,severe cases and ordinary cases were 55.56%（10/18）,36.07%（145/402）and 32.63%（217/665）respectively.The positive rate of different specimens was different.The positive rate of anus swabs and feces was 49.62%.The rate of herpes juice was 43.84%.The positive rate of nasal and throat swabs was 22.89%.Conclusion The major pathogen of HFMD was EV71 and CoxA16 was also one of the pathogen.The pathogenic monitoring of HFMD should be strengthened in order to know the change of virus type and provide technical support for HFMD prevention and control.

关 键 词：手足口病 肠道病毒71型 柯萨奇病毒A16型 实时荧光-聚合酶链式反应 

分 类 号：R512.5[医药卫生—内科学]