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目的了解福建省1996~2002年急性弛缓性麻痹(AFP)病例中检出病毒的型别分布及特点。方法用RD、HEp-2、L20B细胞从AFP病例粪便标本中分离病毒,阳性分离株首先应用脊髓灰质炎(脊灰)病毒(PV)3个型血清鉴定PV型别,PV3个型血清无法中和的病毒再用世界卫生组织(WHO)提供的RIVM诊断组合血清进行非脊灰肠道病毒(NPEV)型别鉴定,继而应用逆转录-聚合酶链反应(RT-PCR)及序列测定与分析对仍无法定型的病毒株进行鉴定,最后对其中鉴定为非EV疑似腺病毒的标本及2株新血清型EV应用电子显微镜技术从形态学方面进行诊断。结果1996~2002年AFP病例中139例病毒分离阳性,其中46例检出PV疫苗相关株,占33.09%,以Ⅱ型为主,其余93例在最初鉴定为NPEV。在能重新扩增出病毒且仍鉴定为NPEV的57例阳性病例标本中,除5例经电镜形态学诊断为腺病毒外,其余52例均为NPEV,涵盖了25个血清型,并以埃柯病毒(ECV)为主(77.78%),常见的有ECV3、11~13型,柯萨奇A、B,各占11.11%、7.41%,同时发现2例新血清型NPEV。结论与无脊灰野病毒前相比,1996~2002年分离的病毒已从1992~1994年以PV为绝大多数转变为以NPEV为主,分离的PV从以Ⅰ型脊灰野病毒为主转变以PVⅡ型疫苗相关株为主。NPEV中血清型分布广泛,不同血清型的流行规律及特点尚待进一步研究。
Objective To understand the type distribution and characteristics of viruses detected in acute flaccid paralysis (AFP) cases in Fujian Province from 1996 to 2002. Methods The virus was isolated from stool samples of AFP cases by using RD, HEp-2 and L20B cells. The positive isolates were identified with three types of poliovirus (PV) And then the virus was re-identified by the World Health Organization (WHO) RIVM diagnostic serotypes of non-polio enterovirus (NPEV) type identification, followed by reverse transcription-polymerase chain reaction (RT-PCR) and sequencing and analysis The unidentified strains were also identified. Finally, morphological analysis was performed on the specimens identified as non-EV suspected adenovirus and two new serotypes of EV using electron microscopy. Results A total of 139 cases of AFP cases were positive in 1996-2002. Of the 46 cases, 46 cases were positive for PV vaccine, accounting for 33.09%. The majority of cases were type Ⅱ. The remaining 93 cases were initially identified as NPEV. Of the 57 positive cases that were able to reproduce the virus and were still identified as NPEV, all but five were diagnosed with adenovirus by electron microscopy and the remaining 52 were NPEV and covered 25 serotypes, (77.78%) were ECV. ECV3, 11-13, Coxsackie A and B were common, accounting for 11.11% and 7.41%, respectively. Two new serotypes of NPEV were also found. Conclusions Compared with the non-poliovirus before, the virus isolated from 1996 to 2002 changed from PV to the vast majority from 1992 to 1994, with NPEV as the main component. The PV isolated from the genotype I poliovirus mainly changed from PV Ⅱ type vaccine-related strains. NPEV serotypes are widely distributed, the prevalence of different serotypes and characteristics of the need for further study.