文档介绍：2009年西安地区手足口病病原血清型分析及肠道病毒71型基因特征
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作者:马超锋,郑海潮,邓惠玲,杜全丽,李一为,杨扬,龚建人,李江博,陈志军
【摘要】目的了解西安地区2009年手足口病的肠道病毒血清型;评价IgM抗体检测在肠道病毒71(EV71)感染早期诊断中的意义;分析西安地区EV71 VP1基因特征。方法分别在西安市城区医院和郊县医院采集的标本共185份,RTPCR法检测标本中的病毒核酸;采集EV71核酸阳性的急性期病例血液标本,ELISA法检测血清中IgM抗体;细胞培养分离EV71,扩增其VP1区,测序并与EV71各血清型代表株序列比对,进行进化分析。结果在185份标本中,156份检出肠道病毒核酸(%),%为EV71,%为柯萨奇A16(CA16);63份EV71核酸阳性的急性期病例血清标本中,45份EV71 IgM抗体阳性(%);分离到的12株EV71均为C4亚型。结论 2009年西安地区手足口病病原以 EV71为主,且主要是C4亚型;ELISA方法可用于EV71感染的早期诊断。
【关键词】手足口病;血清型;肠道病毒71型(EV71);柯萨奇A16(CA16);进化分析
ABSTRACT: Objective To observe the main serotypes of the enteroviruses causing hand
footmouth disease in Xian in 2009, evaluate the availability of IgM assay in EV71 infection and investigate the ic characteristics of Total of 185 samples were collected from urban and suburban hospitals in Xian respectively to identify the serotypes of enteroviruses. EV71 IgM antibody of 63 serum samples from confirmed EV71 infected patients was assayed. Isolated EV71 strains VP1s were sequenced and phyletic evolution was The enterovirus RNA positive rate of pharynx swabs was %, % of viral serotyping was EV71 and % was CA16. Of the serum samples, % were tested EV71 IgM positive, and the serotype of EV71 was EV71 was the main pathogen of HFMD in Xian 2009 and EV71 had a close relation with C4 serotype. EV71 IgM antibody can be used in early diagnosis of EV71 infection.
KEY WORDS: handfootmouth disease; serotype; enterovirus 71; Coxsackie 16; phyletic evolution
手足口病(handfootmouth disease, HFMD)是由一组肠道病毒引起的常见传染病,以发热和手、足、口腔和臀部等部位出现皮疹为主要临床特征。HFMD属自限性疾病,大多数患者预后良好,但有些引起HFMD的病毒还可侵犯呼吸系统、中枢神经系统和心血管系统,引起脑炎、心肌炎、肺水肿、弛缓性麻痹等,个别危重患儿可因多种原因死亡。本病全年均可发生,多发于夏秋季,常见于5岁以下的儿童。本病通过粪口途径、呼吸道和密切接触传播,传染性强,易导致流行或爆发[1]。引起HFMD的病原体主要为小RNA病毒科肠道病毒属的柯萨奇A组的16、2、4、5、7、9、11型,柯萨奇
B组的1、2、3、4、5型,部分埃可病毒和肠道病毒71型。最常见的为柯萨奇A组的16型(CA16)和肠道病毒71型(EV71)[2]。本研究旨在了解西安地区2009年HFMD肠道病毒的血清型,评价IgM抗体检测在EV71