辽阳市手足口病患者标本肠道病毒检测结果

Enterovirus detection results from different samples of patients with hand-foot-mouth disease in Liaoyang

目的通过对辽阳市2016年手足口病的临床诊断病例的咽拭子标本和粪便标本进行肠道病毒核酸检测和病毒分离培养,比较不同病毒分型下两种标本类型阳性率的差异,探究不同类型标本对手足口病实验室诊断的指导意义。方法收集107例辽阳市2016年手足口病的临床诊断病例的咽拭子和粪便标本,提取样本核酸,用实时定量PCR法检测肠道病毒通用引物、肠道病毒71型和柯萨奇病毒A组16型,通过Mc Nemar检验以及Kappa检验对检测结果进行统计学分析。结果配对采集病例两种类型标本共214份,肠道病毒通用引物、肠道病毒71型和柯萨奇病毒A组16型的咽拭子标本核酸检测阳性率分别为48.6%、8.4%、22.4%;粪便标本的核酸检测阳性率分别为59.8%、11.2%、18.7%。PE、EV71病毒的粪便标本的检出率均大于咽拭子标本的检出率,但CV-A16病毒的粪便标本的检出率却小于咽拭子标本的检出率。其他肠道病毒的咽拭子标本和粪便标本的病毒检出率差异有统计学意义(P<0.05),粪便标本肠道病毒检测阳性率高于咽拭子标本,同时显示较差的一致性(P<0.05)。结论在手足口病实验室肠道病毒检测中,粪便标本的肠道病毒检测阳性率高于咽拭子标本,今后的手足口病防治工作中为提高标本检测阳性率,若时间紧迫应首先考虑选择采集粪便标本加以检测。

Objective By detecting throat swab and feces swab samples for enterovirus nucleic acid and culturing isolatevirus of cases with hand-foot-mouth disease in Liaoyang city, we compared the enterovirus-positive rate from throat swab andfeces swab samples of patients with hand-foot-mouth disease, so as to explore the guiding significance of specimens of differenttypes in laboratory diagnosis of HFMD. Methods The enterovirus detection results was paired and collected from 107 casesof HFMD patients in Liaoyang city, and nucleic acids of samples were extracted. Quantitative real-time PCR was used to detectuniversal primers for enterovirus（PE）, enterovirus 71（EV71） and coxsackie virus A16（CVA16）. Results were statisticallyanalyzed by Mc Nemar test and Kappa test. Results A total of 214 samples were paired collected from two types of specimen.The nucleic acid positive rate for PE, EV71 and CVA16 in throat swab samples were 48.6%, 8.4% and 22.4%, respectively; thenucleic acid positive rate for PE, EV71 and CVA16 in feces swab samples were 59.8%, 11.2%, 18.7%, respectively. Thepositive rate of feces swab samples for PE and EV71 was higher than that of throat swab samples, but the positive rate that fecesswab samples of CVA16 was less than that of throat swab samples. The positive rate of other enteroviruses in feces swabsamples was significantly higher than that of throat swab samples, two types of samples also showed poor consistency（P〈0.05）.Conclusions For the virus detection of hand-foot-and-mouth disease in laboratory, the enterovirus-positive rate in fecesswab samples was higher than throat swab samples. In order to improve the positive rate of specimen detection, feces samplesshould be the first choice under the condition of time constraints in the future prevention and control work of hand-foot-mouthdisease.