2013年长春市儿童医院 HFMD 患儿病原特点分析

摘要

Objective Investigated the etiology characteristics of the inpatients with hand-foot-mouth disease in Changchun children’s hospital during 2013.Methods The statuses of 1111 children with HFMD were retrospectively analyzed.The genes of EV,EV71,CAV16 and CVA6 were detected by the method of fluorescent quantitative polymer-ase chain reaction.10 positive samples from 1111 fecal specimens were sequenced.Results Main onset ages of the inpa-tients with HFMD from Changchun children’s hospital were 13-24 months in 2013.Summer (6-8 month )was the high incidence season.EV and CAV6 were major pathogens.The detection rates of the EV and CAV6 were 50.21% and 46.00%.The peak months of EV and CAV6 were 6 month.CAV16 was 10 month.The was no peak month of EV71.7 sequences had high identities to the CAV6.The homology in the VP1 region was 96%-98%.Number 14,19,22 and 23 which had the high homology located in the same branch on phylogenetic tree.Number 5 located in another branch.Con-clusion CAV6 was the dominant genotype of HFMD in Changchun children’s hospital during 2013.There were differ-ent genotypes circulated among children.Monitoring Etiology characteristics of HFMD was important for early preven-tion,diagnosis,treatment,and prognosis.%目的：分析2013年长春市儿童医院住院手足口病（HFMD）患儿病原学特点，了解住院 HFMD 患儿病原的变化。方法分析2013年长春市儿童医院住院的1111例 HFMD 患儿一般情况；应用荧光定量 PCR 方法检出粪便肠道病毒通用型（EV）、新型肠道病毒71型（EV71）、柯萨奇病毒 A16型（CoxA16）和柯萨奇病毒 A6型（CoxA6）核酸；在1111份粪便标本中随机抽取10份进行 CoxA6型核酸序列检测及分析。结果2013年长春市儿童医院住院HFMD 患儿发病高峰年龄段13-24月龄，流行高峰季节6-8月份。引发 HFMD 的病原有 EV、EV71、CoxA16、CoxA6等，以 EV 和 CoxA6为主，阳性检出率分别为50．21％和46．00％；EV 和 CoxA6流行的高峰季节6月份，CoxA16在10月现流行高峰，EV71未出现流行高峰季节。随机抽取10份进行测序，有7份序列与 CoxA6序列的同源性为96％-98％；CoxA6型系统发生学分析显示：其中4份同源性高，位于基因树的同一分支。结论2013年长春市儿童医院住院 HFMD 患儿病原流行优势型为 CoxA6；HFMD 的病原趋于多样性和多种型别共流行的状态。监测 HFMD病原的特点对于其预防、临床诊治及预后评估有重要警示作用。