2011-2014年河北省手足口病病原构成及其他肠道病毒基因进化分析  

Analysis on pathogen population causing hand,foot,and mouth disease and genetic evolutionary characteristics of other enteroviruses in Hebei Province from 2011-2014

作　　者：刘莹莹[1] 赵文娜[1] 刘宏灵 于秋丽[1] 齐顺祥[1] 李琦[1] 

机构地区：[1]河北省疾病预防控制中心病毒病防治所,河北石家庄050021 [2]华北理工大学公共卫生学院,河北唐山063000

出　　处：《中国病原生物学杂志》2016年第11期973-976,981,共5页Journal of Pathogen Biology

基　　金：国家科技重大专项(No.2013ZX10004202);河北省重大医学科研资助项目(No.zd2013068)

摘　　要：目的了解河北省2011-2014年手足口病病原以及其他(非EV71及非CoxA16的肠道病毒)肠道病毒分子遗传进化特征。方法利用描述流行病学方法对河北省2011-2014年疾病监测信息报告系统上报的手足口病病例资料和实验室检测结果进行统计分析,利用DNAstar软件包和MEGA软件分析其他肠道病毒的基因进化特征。结果手足口病病原检测病原构成以EV71为主,阳性率为53.49%,且不同年份病原构成略有不同。在轻症病例中,2012年CoxA16构成比为44.56%,2013年其他肠道病毒构成比为48.54%,但仍有>75%的重症病例和85%的死亡病例由EV71感染引起。CVA6、CVA10、CVA4肠道病毒的分离株与其相应原型株的VP1区核苷酸序列差异均较大,但各型分离株具有较高的内部序列同源性,在进化树上与深圳、上海等相应分离株共进化共循环。结论 EV71是本地区手足口病的主要病原体,但EV71和CVA16感染所占比例总体上呈下降趋势,其他肠道病毒所占比例总体上呈缓慢上升的趋势,加强非EV71、非CoxA16肠道病毒的检测和鉴定分型将有助于手足口病预防和控制。Objective To identify the pathogens and molecular genetic evolutionary characteristics of enteroviruses（non-CA16 and non-EV71enteroviruses）causing hand,foot,and mouth disease（HFMD）in Hebei Province from 2011 to 2014. Methods Cases of HFMD and laboratory results submitted to the Information System for Disease Monitoring were statistically analyzed using descriptive epidemiology,and the genetic evolutionary characteristics of other enteroviruses were analyzed with the software package DNAstar and the program MEGA. Results The most prevalent pathogen detected in cases of HFMD was EV71 and 53.20% of the cases of HFMD tested positive for that pathogen,but EV71 accounted for a slightly different proportion of cases during the years studied.CoxA16 accounted for 44.56% of the cases of mild HFMD in 2012 while other enteroviruses accounted for 48.54% of those cases in 2013.Nonetheless,more than75% of severe cases and 85% of fatal cases were caused by EV71.Compared to their original strains,isolates of the enteroviruses CVA6,CVA10,and CVA4 differed substantially in the nucleotide sequences of the VP1 domain.However,isolates of every genotype had a high level of homology.Phylogenetically,the isolates co-evolved and co-circulated with isolates from other provinces or regions（such as Shenzhen and Shanghai）. Conclusion Generally,EV71 was still the predominant pathogen responsible for HFMD.However,the proportion of cases caused by EV71 and CoxA16tended to decrease while the proportion of cases caused by other enteroviruses slowly increased.In the future,enhanced detection and genotyping of enteroviruses other than EV71 and CoxA16will help to prevent and control HFMD.

关 键 词：手足口病 病原构成 其他肠道病毒 基因进化 

分 类 号：R373.2[医药卫生—病原生物学]