2010年至2012年深圳市手足口病分子流行病学研究  

Molecular epidemiological study of hand, foot and mouth disease in Shenzhen from 2010 to 2012

作　　者：冼慧霞[1] 陈龙[1] 罗敏[1] 姚相杰[1] 杨洪[1] 贺连华[1] 张海龙[1] 何雅青[1] 

机构地区：[1]深圳市疾病预防控制中心重大传染病监测重点实验室、深圳市病原微生物资源库建立与应用公共服务平台,518055

出　　处：《中华传染病杂志》2014年第4期219-224,共6页Chinese Journal of Infectious Diseases

摘　　要：目的 了解2010年至2012年深圳市手足口病病原构成、分子特征和流行病学规律,为制订防制措施提供科学依据.方法 收集2010年至2012年深圳市手足口病疑似患者粪便或肛拭子标本1 523份,实时荧光定量PCR和反转录半套式PCR （RT-snPCR）法进行VP1基因系统进化分析,数据分析行x2检验.结果 手足口病发病以2岁以下儿童居多,其次为2～3岁组;宝安和龙岗区患者数最多;各年龄组性别比较差异有统计学意义（x2=12.365,P=0.030）.2010年至2012年1 523例手足口病患者病原学分析,肠道病毒阳性1 148例,占75.4％,包括肠道病毒71型（EV71）、柯萨奇病毒（Cox）A组和B组、埃可病毒等28种病原;居前4位分别为EV71 （57.1％）、CoxA6（18.5％）、CoxA16 （14.0％）和CoxA10（3.7％）,以A组人肠道病毒（HEV-A）最为普遍（96.2％）.深圳市CoxA6毒株与2008年芬兰、2010年法国和2011年日本毒株亲缘性较近,CoxA10与2007年斯洛伐克、2008年西班牙毒株同源性最高.结论 2010年至2012年深圳市手足口病病原谱以HEV-A组的EV71、CoxA6、CoxA16和CoxA10为主,CoxA6是继EV71之后的第2位主要病原体,深圳市CoxA6毒株可能起源于欧洲和日本.位于深圳北部的宝安区和龙岗区是手足口病的主要分布地区;＜2岁是手足口病高发年龄段.Objective To investigate the pathogen spectrum and molecular epidemiological characteristics of hand,foot and mouth disease （HFMD） in Shenzhen from 2010 to 2012 and to provide scientific basis for HFMD control.Methods A total of 1 523 clinical stool specimens or anal swab from the sentinel surveillance systems of HFMD were obtained.Molecular evolutions of VP1 gene of causative agents were detected by real-time fluorescence quantitative polymerase chain reaction （PCR） and reverse transcription semi nested PCR（RT-snPCR）,which analyzed the molecular evolution of VP1.The data were analyzed by chi-square test.Results Children under two years old were in high incidence of HFMD,followed by 2-3 years old group.The largest number of HFMD cases from 2010 to 2012 was in Baoan and Longgang districts.There were significant differences between male and female among all age groups （x2=12.365,P=0.030）.Totally 1 148 of 1 523 （75.4%） HFMDcases from 2010 to 2012 were found positive for human enterovirus and twenty-eight different genotypes were detected,including Enterovirus （EV71）71,Coxsakievirus （Cox） group A and B,and Echovirus.EV71 （57.1%）,CoxA6 （18.5%）,CoxA16 （14.0%） and CoxA10 （3.7%） were the top four pathogens,enterovirus group A was the most common （96.2%）.CoxA6 strains isolated from Shenzhen were genetically related to those from Finland 2008,France 2010 and Japan 2011,Shenzhen CoxA10 strains showed closest genetic relationship to Slovakia 2007 and Spain 2008.Conclusions The pathogen spectrum of Shenzhen HFMD from 2010 to 2012 are EV71,CoxA6,CoxA16 and CoxA10.The prevalence of Shenzhen CoxA6 ranks second major pathogen of HFMD which may be originated from European countries and Japan.Baoan and Longgang district,locate in the north of Shenzhen are the main distribution area.High incidence of HFMD is 1-2 years old group.

关 键 词：手足口病 肠道病毒A型 人 基因 病毒 序列分析 流行病学研究 

分 类 号：R181.3[医药卫生—流行病学] R725.1[医药卫生—公共卫生与预防医学]