2019年河南省急性弛缓性麻痹病例中非脊髓灰质炎肠道病毒的分子鉴定  

Molecular identification of non-polio enteroviruses in acute flaccid paralysis cases in Henan Province of China in 2019

作　　者：杨建辉[1] 豆巧华 陈艳萍 张璐[1] 郭永豪[1] Yang Jianhui;Dou Qiaohua;Chen Yanping;Zhang Lu;Guo Yonghao(Henan Medicine Key Laboratory of Immunoprophylaxis,Institute of Expanded Immunization Program,Henan Provincial Center for Disease Control and Prevention,Zhengzhou 450016,China)

机构地区：[1]河南省疾病预防控制中心免疫预防与规划所,河南省免疫预防医学重点实验室,郑州450016

出　　处：《中华微生物学和免疫学杂志》2022年第2期134-140,共7页Chinese Journal of Microbiology and Immunology

基　　金：河南省医学科技攻关计划项目(LHGJ20200133)。

摘　　要：目的了解2019年河南省急性弛缓性麻痹(acute flaccid paralysis,AFP)病例中非脊髓灰质炎肠道病毒(non-polio enterovirus,NPEV)的型别及分布情况。方法2019年河南省共报告AFP病例513例,每例病例采集双份粪便标本进行病毒分离,对NPEV阳性毒株进行VP1基因扩增和测序鉴定,序列的比对以及遗传进化树的构建通过MEGA5.1软件完成。使用Excel 2016和SPSS19软件对NPEV阳性毒株的流行病学数据进行统计分析。结果从513例AFP病例中共分离出39株NPEV,分离率为7.60%(39/513),其中18株为A组病毒,21株为B组病毒,A组和B组病毒均包含7个血清型,未分离到C组和D组病毒。A组中以柯萨奇A组病毒(coxsackievirus A,CVA)4型和CVA16为主,B组中以埃可病毒(echovirus,Echo)11型为主。NPEV阳性毒株之间的核苷酸一致性为67.4%~100.0%,与原型毒株核苷酸一致性为71.4%~85.6%。NPEV主要集中在7岁以下的散居儿童当中,分离率为84.62%(33/39),男女性别比为2.07∶1,分离率在不同年龄组之间以及不同性别之间均无统计学差异(P>0.05)。A组病毒中CVA2、CVA4和CVA16分布比较广泛,B组病毒中Echo3、Echo11和Echo30分布比较广泛。时间上除1月份以外,全年均能分离出NPEV,其中A组病毒主要发生在4~7月,分离数占到全年的66.67%(12/18),B组病毒主要发生在9月,分离数占到全年的28.57%(6/21)。结论2019年河南省分离的NPEV以B组Echo11为主要血清型,病原谱、地区分布以及不同年龄NPEV的分离率相比2018年发生了明显的变化。因此要加强监测,有针对性的进行防控,有效减少AFP的发生。Objective To investigate the types and distribution of non-polio enterovirus(NPEV)in acute flaccid paralysis(AFP)cases in Henan Province in 2019.Methods A total of 513 cases of AFP were reported in Henan Province in 2019.Two stool specimens were collected from each case for virus isolation.The VP1 gene of NPEV-positive strains was amplified and sequenced.Sequence alignment and construction of the phylogenetic tree were completed by MEGA5.1 software.The epidemiological data of NPEV-positive strains were statistically analyzed by Excel 2016 and SPSS19 software.Results A total of 39 NPEV strains were isolated from 513 AFP cases,with an isolation rate of 7.60%(39/513).Among them,18 strains were group A viruses and 21 strains were group B viruses.Both group A and group B viruses contained seven serotypes.No viruses of group C and group D was isolated.Coxsackievirus A type 4(CVA4)and CVA16 were the predominant types in group A,and echovirus type 11(Echo11)was the predominant type in group B.The nucleotide identity between the NPEV-positive strains was 67.4%-100.0%,and their nucleotide identity with the prototype strain was 71.4%-85.6%.NPEV was mainly detected in scattered children under 7 years old with an isolation rate of 84.62%(33/39),and the ratio of male to female was 2.07∶1.No statistically significant difference in the isolation rate was found between different age groups or between different sexes(P>0.05).Among the group A viruses,CVA2,CVA4 and CVA16 were widely distributed.Echo3,Echo11 and Echo30 were the widely distributed group B viruses.NPEV could be isolated throughout the year except for January.Group A virus infections mainly occurred from April to July,accounting for 66.67%(12/18)of the whole year.Group B virus infections mainly occurred in September,accounting for 28.57%(6/21)of the whole year.Conclusions The main serotype of NPEV isolated in Henan Province in 2019 was Echo11.The pathogen spectrum and regional distribution of NPEV as well as the isolation rate in different age groups changed signific

关 键 词：急性弛缓性麻痹 非脊髓灰质炎肠道病毒 分子鉴定 流行病学特征 

分 类 号：R512.4[医药卫生—内科学]