一例流感样病例病原检测及遗传进化分析  

Analysis of the Pathogen Detection and Genetic Evolution of An Influenza-like Case

作　　者：王文祥 连宪强 范秋华 WANG Wenxiang;LIAN Xianqiang;FAN Qiuhua(Dapeng New District Center for Public Health Management and Service,Shenzhen 518116,Guangdong Province,China)

机构地区：[1]深圳市大鹏新区公共卫生管理服务中心,广东深圳518116

出　　处：《寄生虫病与感染性疾病》2021年第3期172-176,共5页Parasitoses and Infectious Diseases

基　　金：深圳市大鹏新区科技创新和产业发展专项资金资助项目(项目编号:YL202001-02)。

摘　　要：目的分析1例流感样病例的病原学及分子遗传学特征,为疫情防控和临床治疗提供参考依据。方法采用实时荧光RT-PCR方法对深圳市大鹏新区哨点医院送检的1例流感样病例监测样品进行检测,结果为肠道病毒阳性。扩增毒株的VP1基因并测序,对样本进一步分型鉴定,并运用MEGA7.0软件对VP1基因做遗传进化分析。结果该流感样病例样品常见呼吸道病毒及新型冠状病毒检测均呈阴性,肠道病毒通用型阳性,通过对本例肠道病毒VP1区基因分析,本次送检的流感样病例是由CVA2肠道病毒引起的,系统发育树显示,本例毒株与国内多例参比毒株位于同一分支,均属于CVA2 D基因型,并且与2017年天津和青海的二例毒株亲缘关系较近,与国外CVA2参比毒株位于不同分支,亲缘关系较远,其中包括来自美国的CVA2原型株Fleetwood。结论该起流感样病例是由CVA2毒株引起。肠道病毒在夏秋季节易于检出,在冬季流感高发季节,由肠道病毒引起的流感样病例容易被临床忽视,应加大对肠道病毒引起呼吸道疾病的监测。Objective To analyze the etiological and molecular genetic characteristics of an influenzalike case,and to provide scientific basis for epidemic prevention and control as well as the clinical treatment.Methods The pathogen of the sample from Dapeng new district sentinel hospital of Shenzhen was identified by real-time fluorescent RT-PCR,and sample was enterovirus positive.To further classify the enterovirus isolate.VP1 gene of the enterovirus isolate was amplied.MEGA7.0 software was used to analyze the genetic evolution of VP1 gene.Results The influenza-like case was common respiratory virus and 2019-nCoV negative,while enterovirus positive.The enterovirus isolate was identified as CVA2 based on the phylogenetic tree showed that the enterovirus isolate and reference isolates were located in the same branch,all belong to CVA2 D genotype,and it had a closer relationship with the isolates from Tianjin and Qinghai in 2017.The enterovirus isolate in this study was located in different branches with reference strains from foreign,that included CVA2 prototype Fleetwood strains from the United States.Conclusion This case is caused by CVA2 virus.Enteroviruses are easy to be detected in summer and autumn,while the influenza-like cases caused by enteroviruses were easily be ignored in winter influenza season.Monitoring of respiratory diseases caused by enteroviruses should be strengthened.

关 键 词：柯萨奇病毒A2型 流感样病例 基因型 遗传进化树 

分 类 号：R511.7[医药卫生—内科学] R122.2[医药卫生—临床医学]