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目的了解2010年～2011年郴州市手足口病的病原谱和人肠道病毒71型(HEV71)的基因特征。方法Real-time RT-PCR法检测人肠道病毒核酸;Rd细胞分离HEV71并作VP1区测序分析。结果 2010年的优势毒株为HEV71,呈春末夏初流行高峰;2011年无明显优势毒株,呈夏、冬季两个流行高峰。病例类型与病原体型别的构成比差异有统计学意义(χ2=51.3,P<0.001)。郴州分离株与安徽阜阳株的同源性最高;VP1蛋白质三级结构同源建模预测未发现有意义的突变位点,重症病例与普通病例无明显差异。结论郴州市手足口病疫情具季节性特征,病原体构成各异,HEV71的流行对郴州市手足口病疫情影响较大。分离的HEV71均为C4a基因亚型,其VP1区段未发现与神经毒性相关的突变位点。
Objective To understand the genetic characteristics of HFMD and human enterovirus 71 (HEV71) in Chenzhou from 2010 to 2011. Methods Real-time RT-PCR was used to detect human enteroviral nucleic acid. Rd cells were used to isolate HEV71 and sequenced for VP1 region. Results The predominant strain in 2010 was HEV71, which showed a peak in late spring and early summer. There was no obvious predominant strain in 2011 with two epidemic peaks in summer and winter. There were significant differences in the constituent ratio between the type of cases and the types of pathogens (χ2 = 51.3, P <0.001). Chenzhou isolates had the highest homology with Fuyang strain in Anhui Province. No significant differences were found in the homology modeling of VP1 protein. There was no significant difference between severe cases and common cases. Conclusion The seasonal epidemic situation of hand-foot-mouth disease in Chenzhou City is seasonal and the pathogens are different. The prevalence of HEV71 has a great influence on the epidemic situation of hand-foot-mouth disease in Chenzhou. The isolated HEV71 were all subtypes of C4a gene. No mutation sites related to neurotoxicity were found in the VP1 segment.