肠道病毒亚型在不同人群中的分布特点及致病风险分析

Distribution of enterovirus genotypes in different populations and their pathogenic risk analysis

目的分析肠道病毒不同基因型在正常儿童、腹泻患病儿童、手足口患病儿童和脑炎脑膜炎患病儿童中的分布特点以及对不同肠道病毒致病风险的评估。方法对河北361份正常组粪便标本、273份腹泻组粪便标本以及湖南320份手足口组粪便标本、105份脑炎脑膜炎组脑脊液标本和182份正常组粪便标本采用巢氏一步方法检测标本中肠道病毒,并对阳性标本进行测序分析基因型。结果河北361份正常组粪便标本阳性率为16.34%(59/361)。273份腹泻组粪便标本阳性率为18.68%(51/273)。湖南320份手足口组粪便标本阳性率为85.31%(273/320)。105份脑炎脑膜炎组脑脊液阳性率为23.81%(25/105),182份正常组粪便标本阳性率为18.68%(34/182)。阳性率差异在5组患儿中有统计学意义(χ2=466.4,P<0.0001)。结论肠道病毒在5组患儿分布存在差异,统计结果显示,肠道病毒是导致腹泻的危险因素,EV71和CVA与患手足口病高度相关,EV71与脑炎脑膜炎患病存在相关关系。

Objective To analyze the c distribution of enterovirus genotypes in healthy children,children with diarrhea,children with hand foot and mouth disease and children with encephalitis and meningitis and to assess their pathogenic risks.Methods Totally 273 fecal specimens of diarrhea group,361 fecal specimens of healthy group from Hebei province,320 fecal specimens from hand– foot–and-mouth disease group and 105 cerebrospinal fluid(CSF)samples of encephalitis meningitis group,182 fecal specimens of healthy group from Hunan province were examined by real-time nested RT-PCR(RTN RT-PCR)assay in a single closed tube.The positive samples were further sequenced to determine the genotype of the enterovirus for analysis.Results The positive rate in 361 fecal specimens from healthy group of Hebei province was 16.34%(59/361).The 273 fecal specimens of diarrhea group showed a positive rate of 18.68%(51/273).The 320 fecal specimens of hand-foot-andmouth disease group from Hunan showed a positive rate of 85.31%(273/320).The 105 CSF samples of encephalitis meningitis group had a positive rate of 24%(25/105).And the positive rate of 182 fecal specimens of healthy group was 18.68%(34/182).The positive rates in the 5 groups were statistically significant(χ^2=466.4,P<0.0001).Conclusion The distribution of enterovirus in 5 different populations is different.Statistical analysis indicates that RV is a risk factor of diarrhea.EV71 and CVA are highly correlated with hand-foot-and-mouth disease.EV71 is correlated to encephalitis meningitis.