疱疹性口炎与疱疹性咽峡炎的病原学检测  

Pathogen detection of herpetic stomatitis and herpangina

作　　者：夏蝉[1] 余坚[2] 金龙腾[1] 温正旺[1] 陈益平[1] 

机构地区：[1]温州医科大学附属第二医院儿童感染科,浙江温州325003 [2]温州医科大学附属第二医院检验科

出　　处：《中华全科医学》2016年第10期1719-1722,共4页Chinese Journal of General Practice

基　　金：浙江省温州市科技计划项目(Y20130364)

摘　　要：目的研究临床诊断疱疹性口炎与疱疹性咽峡炎病例的病原学特点,并进行比较。方法选择2015年3月1日—8月31日临床诊断为疱疹性口炎病例60例和疱疹性咽峡炎50例纳入本次研究,胶体金法检测EV71、Cox A16两种肠道病毒,ELISA法检测疱疹病毒Ⅰ型、Ⅱ型,RT-PCR法检测肠道病毒5’-UTR基因片段、EV71 VP1及Cox A16 VP1基因片段,PCR法检测疱疹病毒Ⅰ型和Ⅱ型糖蛋白基因片段,比较2种疾病病原学的差异。结果疱疹性口炎病原学PCR结果显示:疱疹病毒检测阳性例数38例,肠道病毒检测阳性例数18例,另有4例未明确病原;Ig M结果显示:疱疹病毒阳性例数35例,肠道病毒阳性例数11例。疱疹性咽峡炎病原学PCR结果显示:疱疹病毒检测阳性例数2例,肠道病毒检测阳性例数38例;Ig M结果显示:疱疹病毒阳性例数2例,肠道病毒阳性例数35例。临床诊断为疱疹性口炎与疱疹性咽峡炎的病例,部分病原学结果存在交互。结论疱疹性口炎和疱疹性咽峡炎的临床诊断可能存在一定的混淆,通过ELISA法和胶体金法,可快速确定病原,而PCR检测方法在部分难以明确病原的病例可进一步检验。Objective To study and compare the pathogen characteristics of patients with herpes stomatitis and herpangina. Methods From March 1,2015 to August 31,2015,60 cases diagnosed clinically as herpetic stomatitis and 50 cases as herpangina were included in this study. Colloidal gold assay was used for the detection of two kinds enterovirus of Cox- A16 and EV71 ,ELISA was used for the detection of herpes virus Ⅰ and Ⅱ,RT-PCR method was used for the detection of enterovirus 5＇ -UTR gene fragment,EV71 VP1 and CoxAl6 VP1 sequence,PCR was used for the detection of herpes virus Ⅰ and Ⅱ glycoprotein gene sequences. The pathogen differences of the two diseases were compared. Results For patients with Herpes stomatitis, PCR results showed the positive herpes virus in 38 cases ,positive intestinal virus in 18 cases, not clear pathogen in 4 cases;IgM results showed positive herpes virus in 35 cases, positive intestinal virus in 11 cases. For Herpangina, PCR results showed positive herpes simplex virus in 2 cases, positive intestinal virus in 38 cases;IgM results showed positive herpes virus in 2 cases, positive intestinal virus in 35 cases. In the cases diagnosed clinically as herpetic stomatitis and herpangiua cases, some pathogenic results were intersectional. Conclusion There may be some cordhsion between the clinical diagnosis of herpes stomatitis and herpangina, the pathogen can be rapidly determined by ELISA and colloidal gold method, and the PCR detection method can be further carried in some cases that is difficult to identify.

关 键 词：疱疹性口炎 疱疹性咽峡炎 肠道病毒 胶体金法 

分 类 号：R781.53[医药卫生—口腔医学] R766.12[医药卫生—临床医学]