2015年杭州市手足口病肠道病毒71型和柯萨奇病毒A组16型构成变化与联合检测方法分析
Changes in pathogen constituent of EV71 and Cox A16 and combined detection methods of hand foot and mouth disease in Hangzhou, 2015
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摘要: 目的 采用肠道病毒核酸和抗体检测,分析2015年杭州市手足口病肠道病毒71型(EV71)和柯萨奇病毒A组16型(Cox A16)构成变化及检测方法学评价。方法 收集2015年4-8月手足口病患儿663例,采用荧光定量反转录-聚合酶链反应(RT-PCR)检测肠道病毒核酸,采用酶联免疫吸附试验(ELISA)检测血清EV71-IgM、Cox A16-IgM。结果 663例手足口病患儿通用核酸阳性组58.52%(388/663),EV71组19.16%(127/663),与2014年比较,通用核酸阳性组比例(2=166.306,P=0.000),EV71组比例(2=134.418,P=0.000)差异有统计学意义。手足口病患儿轻症487例,占73.45%,以通用核酸阳性组65.91%(321/487)为主;重症176例,占26.55%,EV71组43.75%(77/176)、通用核酸阳性组38.07%(67/176)位居前2位。不同组别出现重症的比例(2=98.395,P=0.000)差异有统计学意义,EV71出现重症比例最高,为60.63%(77/127)。病毒核酸检测和血清抗体检测阳性率比较差异有统计学意义(2=44.487,P=0.000)。其中,127例EV71阳性患儿,核酸和抗体检测双阳性率为59.85%(76/127),单阳性率为40.15%(51/127);64例Cox A16阳性患儿,核酸和抗体检测双阳性率为9.38%(6/64);单阳性率为90.62%(58/64)。以核酸定量RT-PCR为标准,EV71/Cox A16-IgM抗体特异度86.61%,敏感度69.49%。结论 2015年与2014年比较,杭州市手足口病病原学流行特征有明显变化。采用病毒核酸和抗体联合检测,可提高实验室的检测阳性率,临床分型有助于辅助指导临床治疗;通用型重症病例增多,需寻找更适合的联合检测方法。
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关键词:
- 手足口病 /
- 病毒核酸检测 /
- 肠道病毒71型 /
- 柯萨奇病毒A组16型
Abstract: Objective To analyze the changes in pathogen constituent of Human enterovirus 71 (EV71) and Coxsachie virus A16 (Cox A16) in children with hand foot and mouth disease(HFMD) in Hangzhou in 2015 and the characteristics of laboratory diagnostic methods of HFMD. Methods A total of 663 children diagnosed with HFMD from April 2015 to August 2015 were enrolled in this study. Enterovirus nucleic acid were detected by fluorescence quantitative RT-PCR and serum antibody of EV71 IgM and Cox A16 IgM were detected by enzyme-linked immunosorbent assay (ELISA). Results Among the 663 children with HFMD, 388 (58.52%) were common nucleic acid positive and 127 (19.16%) were EV71 positive. Compared with the data of 2014, the differences in proportions of common nucleic acid positive group (2=166.306,P=0.000) and the EV71 positive group were significant (2=134.418, P=0.000), and 487 cases (73.45%) were mild ones, mainly in common nucleic acid positive group (65.91%, 321/487), and 176 cases (26.55%) were severe ones, mainly in EV71 positive group(43.75%, 77/176) and common nucleic acid positive group (38.07%, 67/176).The probability of severe cases was different in different groups (2=98.395, P=0.000). The severe case proportion was highest in EV71 group (60.63%, 77/127). The difference in positive rate between nucleic acid detection and serum antibody detection was significant (2=44.487, P=0.000). In 127 cases of EV71 infection, 59.85%(76/127)were positive in both nucleic acid detection and serum antibody detection, 40.15% (51/127) were either nucleic acid positive or serum antibody positive. In 64 cases of Cox A16 infection, 9.38%(6/64) were positive in both nucleic acid detection and serum antibody detection, 90.62%(58/64) were either nucleic acid positive or serum antibody positive. With the quantitative RT-PCR as the standard, the specificity in detection of EV71 and Cox A16 was higher (86.61%), but the sensitivity was lower relatively (69.49%). Conclusion Compared with 2014, the epidemic features of HFMD changed obviously. The detection of virus nucleic acid and antibody can increase the positive rate of laboratory detection, and clinical classification can facilitate the clinical treatment. As the increase of severe cases in common nucleic acid positive group, it is necessary to find a more suitable detection method. -
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[1] WangJJ,CaoZD,ZengDD,etal.Epidemiologicalanalysis,detection,andcomparisonofspace-timepatternsofBeijinghand-foot-mouthdisease(2008-2012)[J].PLoSOne,2014,9(3):e92745.
[1] XingWJ,LiaoQH,ViboudC,etal.Hand,foot,andmouthdiseaseinChina,2008-12:anepidemiologicalstudy[J].LancetInfectDis,2014,14(4):308-318.
[2] WuYD,ZhouJ,ChenD,etal.Applicationofcombineddetectionofenterovirusnucleicacidandantibodyinearlyetiologicaldiagnosisforhand-foot-and-mouthdisease[J].ChineseJournalofLaboratoryMedicine,2015,38(6):397-401.(inChinese)吴亦栋,周俊,陈东,等.肠道病毒核酸与抗体联合检测在手足口病病原早期诊断中的应用[J].中华检验医学杂志,2015,38(6):397-401. [3] MinistryofHealthofthePeople'sRepublicofChina.Diagnosisandtreatmentguidelineonhand-foot-mouthdisease(2010)[J].InternationalJournalofRespiration,2010,30(24):1473-1475.(inChinese)中华人民共和国卫生部.手足口病诊疗指南(2010年版)[J].国际呼吸杂志,2010,30(24):1473-1475. [4] MaJT,YuanF,ChenH,etal.GeneticcharacteristicsofVP1regionofcoxsackievirusA10strainsisolatedfromhandfootandmouthdiseasepatientsinNingxiaHuiAutonomousRegion,2013[J].ChineseJournalofEpidemiology,2015,36(7):734-737.(inChinese)马江涛,袁芳,陈慧,等.宁夏回族自治区2013年手足口病患者柯萨奇病毒A组10型分离株VP1区基因特征分析[J].中华流行病学杂志,2015,36(7):734-737. [5] YueMN,WuYD,ZhouJ,etal.ThetestingresultsanalysisofenterovirusfromchildreninfectedwithHFMD[J].ChineseJournalofHealthLaboratoryTechnology,2014,24(22):3262-3264.(inChinese)岳美娜,吴亦栋,周俊,等.手足口病患儿肠道病毒检测结果分析[J].中国卫生检验杂志,2014,24(22):3262-3264. -
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