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目的监测邵阳市手足口病病原情况,为制定预防和控制肠道病毒感染提供依据。比较评价检测方法、标本类型及采样时间对病原学诊断的意义。方法采用实时荧光定量PCR方法和RT-PCR方法,进行EV71、CoxA16和其他肠道病毒的核酸检测。结果肠道病毒阳性率为63.38%,其中EV71阳性率为40.61%,CoxA16阳性率为7.97%,其他肠道病毒阳性率为14.80%。男女阳性率分别为65.07%和59.88%。阳性病例0~岁到5~岁组构成比为97.60%。咽拭子肠道病毒阳性率61.60%,疱疹液肠道病毒阳性率80.0%,粪便或肛拭子肠道病毒阳性率75.0%。重症病例肠道病毒阳性检出率为67.43%,轻症病例标本阳性检出率60.71%。109份标本实时荧光定量PCR和RT-PCR比较结果差异有统计学意义。结论 EV71是引起邵阳市儿童手足口病的主要病原体,男性EV71阳性检出率高于女性,5岁以下儿童是高危人群,春夏季高发,不同类型标本的阳性检出率差异有统计学意义,实时荧光定量PCR阳性检出率高于RT-PCR,重症病例EV71检出率高于轻症病例,要加强对EV71和CoxA16的鉴别诊断,有利于提出更好的预防和控制措施。
Objective To monitor the pathogen of hand, foot and mouth disease in Shaoyang and provide basis for prevention and control of enterovirus infection. The comparative evaluation of detection methods, specimen types and sampling time on the significance of etiological diagnosis. Methods Real-time fluorescence quantitative PCR and RT-PCR were used to detect the nucleic acid of EV71, CoxA16 and other enteroviruses. Results The positive rate of enterovirus was 63.38%. The positive rate of EV71 was 40.61%, the positive rate of CoxA16 was 7.97%, and the positive rate of other enterovirus was 14.80%. The male and female positive rates were 65.07% and 59.88% respectively. Positive cases 0 ~ 5 to the age group composition ratio of 97.60%. The positive rate of throat swab enterovirus was 61.60%, the positive rate of herpes liquid enterovirus was 80.0%, and the positive rate of enterovirus of stool or anal swab was 75.0%. Severe cases of enterovirus positive detection rate of 67.43%, mild cases of positive detection rate of 60.71%. The results of 109 real-time fluorescence quantitative PCR and RT-PCR showed statistically significant difference. Conclusion EV71 is the major cause of hand, foot and mouth disease in children in Shaoyang City. The positive rate of EV71 in male is higher than that in female. Children under 5 years old are at high risk. In spring and summer, the positive rate of EV71 is statistically significant, The positive rate of real-time PCR was higher than that of RT-PCR, and the detection rate of EV71 in severe cases was higher than that of mild cases. To improve the differential diagnosis of EV71 and CoxA16, it is propitious to put forward better prevention and control measures.