2008年广东省手足口病实验室检测结果分析

Analysis of the laboratory diagnosis results of hand-foot-mouth disease in Guangdong Province,2008

目的对广东省2008年手足口病实验室检查结果进行分析,了解2008年广东省手足口病病原学特征,为实验室诊断手足口病提供参考。方法采集2008年4—12月广东省各地送检的292例手足口病患者的粪便、肛拭子、咽拭子、疱疹液和脑脊液等标本426份和98名手足口病病例接触者的粪便、肛拭子和咽拭子等标本98份,应用RT-PCR技术检测样本中的肠道病毒、肠道病毒71型(EV71)、柯萨奇病毒A组16型(CVA16)。结果292例手足口病患者的426份各类样本中,检测到肠道病毒阳性267份,EV71病毒特异性基因片段阳性169份,CVA16特异性基因片段阳性36份,EV71和CVA16病毒核酸同时阳性3份。292例手足口病病例中,EV71的检出率较CVA16高,分别为50.68%(148/292)和11.99%(35/292),20例手足口病死亡病例均为EV71感染病例。手足口病病例粪便样本的肠道病毒、EV71和CVA16的检测阳性率最高,分别为76.72%(178/232)、45.26%(105/232)和14.66%(34/232),且在发病9 d后仍能检测到EV71病毒。98名手足口病病例接触者的各类样本中,分别检测到肠道病毒、EV71和CVA16特异性基因片段阳性34、9和2份。结论EV71是2008年广东省手足口病的优势病原体;同时EV71是引起手足口病死亡和重症病例的主要毒株类型。

Objective To understand the pathogen characters of hand-foot-mouth disease （HFMD） and provide reference for laboratory diagnosis of HFMD. Methods A total of 524 samples including throat swabs, Herpes fluid, anal swab, feces, and other types from 292 patients and 98 close contacts all over Guangdong Province were collected from April to December in 2008. Nucleic acids of three types of viruses of enterovirus , enter virus 71 （EV71） and Coxasckievirus A16 （CVA16） were detected by RT - PCR method both in original samples and isolated positive virus strains. Results In 426 samples from the patients, 267 were enterovirus positive, of which, 169 were EV71, 36 were CVA16 and 3 were both EV71 and CVA16. In 98 samples from the closed contacts , 34 were enterovirus positive, of which, 9 were EV71and 2 were CVA16. The feces samples were of highest positive rate, i. e. , the enterovirus was 76.72% （ 178/252）, the EV71 was 45.26% （ 105/232）, and the CVA16 was 14.66% （34/232）. Moreover, the feces samples were able to be detected EVT1 positive even at the ninth day after disease onset. In the 292 HFMD cases, the EV71 positive rate was 50.68% , and the CVA16 positive rate was 11.99%. The 20 fatal cases were all EV71 positive. Conclusion EV71 was the dominant pathogen of the HFMD in Guangdang Province in 2008, and the major enterovirus causing HFMD fatal and severe cases.