2015—2018年青海省手足口病病原谱变化和流行趋势  

Hand,foot and mouth disease pathogen changes and epidemic trends in 2015-2018,Qinghai province

作　　者：刘桂香[1] 汪春翔[1] 赵生仓 李崇亥 王晓彤 任丽萍[2] 严冬梅[3] 冀天娇[3] 范丽霞[1] Liu Guixiang;Wang Chunxiang;Zhao Shengcang;Li Chonghai;Wang Xiaotong;Ren Liping;Yan Dongmei;Ji Tianjiao;Fan Lixia(Qinghai Provincial Center for Disease Control and Prevention,Xining 810007,China;Liaoning Provincial Center for Disease Control and Prevention,Shengyang 110005,China;National Institute for Viral Disease Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 102200,China)

机构地区：[1]青海省疾病预防控制中心,西宁810007 [2]辽宁省疾病预防控制中心,沈阳110005 [3]中国疾病预防控制中心病毒病预防控制所,北京102206

出　　处：《中华实验和临床病毒学杂志》2022年第3期296-299,共4页Chinese Journal of Experimental and Clinical Virology

基　　金：国家重大传染病专项(2017ZX10103006)。

摘　　要：目的了解青海省手足口病(hand,foot and mouth disease,HFMD)患者中肠道病毒流行情况和基因型特征。方法采集青海省HFMD患者的咽拭子标本,进行病毒分离和特异性引物聚合酶链反应(RT-PCR),对扩增产物进行核苷酸序列测定和分析,并参考NCBI部分毒株序列构建基因进化树。结果采集临床诊断HFMD阳性病例标本1738份,其中人肠道病毒A组71型(EV-A71)型326例,占18.76%、人肠道病毒柯萨奇A16型(CV-A16)型237例,占13.64%、人肠道病毒柯萨奇A6型(CV-A6)型628例,占36.13%,4年间不同基因型别间存在差异,具有统计学意义(EV-A71,χ^(2)=245.315,P<0.001;CV-A16,χ^(2)=27.680,P<0.001;CV-A6,χ^(2)=702.713,P<0.001),用RD细胞分离后共得到到317株细胞培养物,测序后选取2017年和2018年典型基因型的VP1区核酸序列进行序列分析,全部基因型VP1区核酸序列间同源性在59%~100%之间,19株EV-A71VP1序列间核苷酸同源性分别在93%~100%之间,20株CV-A16型核酸VP1序列的同源性在92%~100%之间,6株CV-A6型VP1核酸序列的同源性在97%~99%之间。从进化树图上看,青海省流行的EV-A71毒株序列全都在进化树图的C4a分支上;CV-A16型分离到20个毒株序列出现在进化树图上的分为两个基因型别,18株为B1b,2株为1D基因型;CV-A6型分离到5个毒株为D3基因型,1株属于B1型。结论青海省2015—2018年HFMD的流行基因型别由EV-A71向CV-A16和CV-A6转变,青海省流行的EV-A71型一直是C4a基因型,CV-A16和CV-A6存在不同的基因型别,不同基因型间核酸序列差异性较大,同一基因间序列变异较小。Objective To understand the prevalence and genotype characteristics of enterovirus and Coxsackie virus in hand,foot and mouth disease(HFMD)patients in Qinghai province from 2015 to 2018.Methods The throat swabs of HFMD patients were collected for virus isolation and RT-PCR in Qinghai province.The nucleotide sequence of the amplified products was determined and analyzed,and the gene evolution tree was constructed with reference to the sequence of some strains of NCBI.Results From 2015 to 2018,1738 samples of clinical diagnosis positive cases were collected,including 326 EV-A71 cases,accounting for 18.76%,237 CV-A16 cases,accounting for 13.64%,628 CV-A6 cases,accounting for 36.13%.There were statistically significant differences among different genotypes in 4 years(EV-A71,χ^(2)=245.315,P<0.001;CV-A16,χ^(2)=27.680,P<0.001;CV-A6,χ^(2)=702.713,P<0.001).A total of 317 cell culture isolates were obtained after isolation with RD cells.After sequence,DNA sequences of typical genotypes were selected for sequence analysis,from 2017 to 2018.The homology of all genotypes of VP1 was between 59%and 100%,the homology was 93%to 100%in 19 strains of EV-A71,the homology was 92%to 100%in 20 strains of CV-A16,the homology was 97%to 99%in 6 strains of CV-A6.According to the evolutionary tree,the sequences of EV-A71 strains are all on the C4a branch of the evolutionary tree in Qinghai province;18 strains of CV-A16 were B1b and 2 stains were 1D;5 strains of CV-A6 were D3 and 1 was B1.Conclusions From 2015 to 2018,the prevalent genotypes of HFMD shifted from EV-A71 to CV-A16 and CV-A6 in Qinghai province,The EV-A71 genotype in Qinghai province has always been C4a genotype.There are different genotypes of CV-A16 and CV-A6.The nucleotide sequence differences between different genotypes are large,and the sequence variation among the same gene is small.

关 键 词：手足口病 病原谱 流行趋势 

分 类 号：R725.1[医药卫生—儿科] R181.3[医药卫生—临床医学]