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目的探讨杭州市手足口病病原谱构成及其肠道病毒71型(human enterovirus 71,EV71)的分子特征。方法采集210例疑似手足口病感染者的粪便标本及其相关临床资料,采用实时荧光定量反转录聚合酶链反应(real time RT-PCR)方法进行初步检测,利用RT-PCR扩增部分EV71和柯萨奇病毒A组16型(coxsackievirus A16,Cox A16)阳性样本VP1基因区并测序分析。结果荧光定量RT-PCR检测表明,210例疑似感染者的粪便中,EV71、Cox A16和其他肠道病毒的阳性率分别为60.95%(128/210)、21.43%(45/210)和9.05%(19/210)。10株EV71病毒VP1区核酸序列与JX509922、JX509924、JX509926、JX509927、JX509928和JX509929的同源性最高为95.7%～98.0%,且均属于EV71中C4a亚型。结论 EV71和Cox A16是杭州市儿童手足口病的主要病原体。因此加强EV71和Cox A16的监测特别是EV71的检测,有助于更好地预防和控制手足口病。
Objective To investigate the molecular structure of HFMD and its molecular characteristics of human enterovirus 71 (EV71) in Hangzhou. Methods Totally 210 stool specimens and their related clinical data were collected from 210 infected persons with hand-foot-mouth disease. Real-time RT-PCR was used to detect the stool specimens. Some EV71 And coxsackievirus A16 (Cox A16) positive samples VP1 gene region and sequencing analysis. Results The positive rate of EV71, Cox A16 and other enterovirus in stool of 210 suspected infected patients was 60.95% (128/210), 21.43% (45/210) and 9.05% respectively by fluorescence quantitative RT-PCR. (19/210). The highest homology of VP1 region of EV71 virus to that of JX509922, JX509924, JX509926, JX509927, JX509928 and JX509929 was 95.7% ~ 98.0%, and all belong to C4a subtypes of EV71. Conclusion EV71 and Cox A16 are the major pathogens of hand-foot-mouth disease in children in Hangzhou. Therefore, strengthening the monitoring of EV71 and Cox A16, especially the detection of EV71, will help to better prevent and control HFMD.