一例儿童手足口病分离毒株特征分析  

Analysis of the etiological characteristics of hand,foot,and mouth disease in a child in Hebei

作　　者：任常军[1] 万丽[2] 王娜[1] 郝玲[1] REN Chang-jun WAN Li WANG Na HAO Ling(The First Hospital of Hebei Medical University, Shijiazhuang 050030 China Shijiazhuang Center for Disease Control and Prevention)

机构地区：[1]河北医科大学第一医院,河北石家庄050030 [2]石家庄市疾病预防控制中心流行病防治所

出　　处：《中国病原生物学杂志》2017年第1期67-70,共4页Journal of Pathogen Biology

摘　　要：目的了解河北地区1例儿童手足口病病原学特征。方法采集1例手足口病患儿支气管病理组织切片并做免疫组化分析。培养病变组织标本并分离EV71。经RT-PCR扩增EV71毒株基因及其VP1区基因,经基因测序并构建进化树,分析毒株病原特征。结果患儿支气管黏膜脱落,甚至发生坏死并伴有淋巴细胞浸润,局部小血管内形成小血栓。免疫组化分析,在支气管组织细胞中检测到阳性抗原信号,且主要集中在上皮细胞的胞浆内。RT-PCR扩增,EV71基因目的片段长度约为226bp。确定EV71阳性的标本采用RT-PCR扩增EV71毒株的VP1区基因序列,目的片段大小约为839bp。基因测序及核苷酸序列比对显示,所测序列未发生突变。构建EV71-VP1区核苷酸序列进化树,本研究中的EV71毒株属于C4亚型,其与FJ606448株的同源性达99%,未发生基因突变。结论本研究分离的EV71毒株未发生变异,与北京流行毒株同属于C4亚型,同源性较高,揭示人口流动对EV71病毒株传播影响的重要性,为河北地区儿童手足口病的临床防治提供指导。Objective A case of hand,foot,and mouth disease in a child in the Hebei region was examined to ascertain the etiological characteristics of hand,foot,and mouth disease. Methods Pathology specimens from a bronchial biopsy of a child with hand,foot,and mouth disease were collected and immunohistochemical analysis was performed.The tissue specimens were cultured to isolate EV71.Genes and the VP1 region of the EV71 virus were amplified with RT-PCR,and the characteristics of the viral pathogen were analyzed using gene sequencing and an evolutionary tree. Results The mucous membrane of the bronchia had sloughed off,and necrosis and lymphocyte infiltration were noted.Small thrombi had formed in small blood vessels in the area.Immunohistochemical analysis revealed that antigens were detected in cells of bronchial tissue and were mainly concentrated in the cytoplasm of epithelial cells.Amplification with RT-PCR revealed that the fragment of the target gene of EV71 was about 226 bp in length.After specimens with EV71 were identified,the gene sequence of the VP1 region of EV71 was amplified with RT-PCR,and the target fragment was about 839 bp in length.Gene sequencing and the comparison of nucleotide sequences indicated that the sequence had not mutated.An evolutionary tree was constructed for the nucleotide sequence of the VP1 region of EV71.The strain of the EV71 virus that was isolated in this study was subtype C4.Its similarity to the FJ606448 strain was 99%,so there were no gene mutations. Conclusion The EV71 isolate did not have mutations.Together with strains prevalent in Beijing,the EV71 strain that was isolated in this study was subtype C4,and the 2groups of strains were highly similar.Results indicated the significant effect of human migration on the spread of EV71.This finding could help guide the clinical prevention and treatment of hand,foot,and mouth disease in children in the Hebei region.

关 键 词：手足口病 病原特征 EV71 系统进化树 

分 类 号：R512.5[医药卫生—内科学]