2010-2012年浙江省奉化市231例手足口病病原监测结果及病毒聚类分析  

Enterovirus monitoring and virus cluster analysis of 231 cases clinically diagnosed hand-foot-mouse disease during 2010 to 2012 in Fenghua,Zhejiang of China

作　　者：周建芳 陈嘉臻[2] 缪忻余[2] 杨珊明 周玲叶 汪亚芬 陈志勇 王刚 俞侠健 沈瑶杰[2] 孙峰[2] 张文宏[2] 

机构地区：[1]浙江省奉化市人民医院,浙江奉化315500 [2]复旦大学附属华山医院,上海200040

出　　处：《中国病毒病杂志》2013年第4期284-289,共6页Chinese Journal of Viral Diseases

基　　金：浙江省医药卫生科技计划项目(2012KYB191)

摘　　要：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 identify enterovirus from clinically diagnosed hand-foot-mouth disease （HFMD） pa- tients during 2010 to 2012 and the dominant subtypes in Fenghua city of Zheiiang, China. Methods A total of 287 specimens including plasma, stools and throat swabs from 231 clinical diagnosed HFMD patients were col- lected. Nested-PCR was performed to detect enteroviruses. For enterovirus positive specimens, genotyping and clustering analysis were performed using 5＇ UTR sequences. Results Among all of the 287 specimens, 167 were detected enterovirus positive and 75 （51.7%） were identified as enterovirus 71 （EV71）, 48 （33.1%） as Coxsackievirus A16 （CVA16） and 12 （8.3%） as other enteroviruses which include CVA4, CVA6, CVA10, CVA12, Coxsackievirus B3 （CVB3） and CVA16. Clustering analysis showed high sequence con eordance among all EV71 strains. CVA16 strains were clustered into three groups. However, CVB3 and CVA10 strains showed small variations comparing to the closest known sequences. Conclusions The majorpathogens causing hand-foot mouth disease in Fenghua city of Zhejiang in China from 2010 to 2012 were EV71 andCVA16. In 2010-2011, the dominant pathogen wasEV71; but in 2012 it wasCVA16.

关 键 词：手足口病 肠道病毒 分子分型 聚类分析 

分 类 号：R725.1[医药卫生—儿科]