济南市2012~2017年手足口病4种优势肠道病毒阳性及VP1基因型分布

doi:10.6040/j.issn.1671-7554.0.2021.0278

摘要/Abstract

摘要：

目的: 阐明济南市手足口病优势肠道病毒感染类型及VP1基因型分布。方法: 采用实时荧光定量逆转录-聚合酶链反应(RT-PCR)对2012~2017年济南市4929份手足口病病例标本进行肠道病毒71型(EV-A71)、柯萨奇病毒A组16型(CV-A16)、柯萨奇病毒A组6型(CV-A6)和柯萨奇病毒A组10型(CV-A10)进行鉴定。按照不同年份回顾性收集手足口病病毒分离株65株，包括17株EV-A71、16株CV-A16、20株CV-A6和12株CV-A10。采用RT-PCR方法扩增肠道病毒VP1特异性基因并进行核苷酸序列测定；获得的目的基因序列进行核苷酸同源性分析并构建系统进化树。结果: 济南市手足口病优势肠道病毒类型为CV-A16(28.3%)、EV-A71(27.3%)、CV-A6(17.0%)、CV-A10(3.0%)。4种优势肠道病毒VP1基因目的片段长度分别为891 bp、1 015 bp、1 110 bp和993 bp。济南市EV-A71病毒株间核苷酸序列同源性为93.0%~98.1%，CV-A16为87.4%~100.0%，CV-A6为87.6%~99.7%，CV-A10为95.8%~99.4%。系统进化树分析显示，济南市EV-A71均为C4a亚型；CV-A16存在B1b型和B1a型两种基因亚型；CV-A6在系统进化树的C簇、E簇和F簇均有分布；CV-A10全部位于进化树E簇。结论: CV-A16、EV-A71、CV-A6和CV-A10为济南市2012~2017年手足口病的优势肠道病毒；长期动态监测肠道病毒VP1基因型分布，对于提高手足口病预警敏感性具有重要的公共卫生意义。

关键词: 手足口病, 肠道病毒, VP1基因, 系统进化分析

Abstract:

Objective: To elucidate the dominant enteroviruses associated with hand, foot and mouth disease (HFMD) and the distributions of VP1 genotypes in Jinan City. Methods: Real-time quantitative reverse transcription-polymerase chain reaction (RT-PCR) was used to detect enterovirus A71 (EV-A71), coxsackievirus A16 (CV-A16), coxsackievirus A6 (CV-A6) and coxsackievirus A10 (CV-A10) in 4929 HFMD specimens from 2012 to 2017 in Jinan. According to different years, 65 virus isolates of HFMD were retrospectively collected, including 17 strains of EV-A71, 16 of CV-A16, 20 of CV-A6 and 12 of CV-A10. The VP1 gene of enteroviruses was amplified by RT-PCR and the nucleotide sequencing was performed. Nucleotide homology analyses were performed and phylogenetic trees were constructed on the VP1 gene. Results: The dominant enteroviruses of HFMD were CV-A16 (28.3%), EV-A71(27.3%), CV-A6(17.0%) and CV-A10(3.0%) in Jinan. The lengths of VP1 gene on CV-A16, EV-A71, CV-A6 and CV-A10 amplified by RT-PCR were 891 bp, 1 015 bp, 1 110 bp and 993 bp, respectively. The nucleotide homology was 93.0%-98.1% for EV-A71 strains, 87.4%-100.0% for CV-A16 strains, 87.6%-99.7% for CV-A6 strains, and 95.8%-99.4% for CV-A10 strains. The phylogenetic trees showed that EV-A71 strains belonged to C4a genotype in Jinan, CV-A16 strains had two genetic subtypes (B1b and B1a); CV-A6 strains located in clusters C, E and F, and CV-A10 strains located in cluster E. Conclusion: The dominant enteroviruses of HFMD are CV-A16, EV-A71, CV-A6 and CV-A10 from 2012 to 2017 in Jinan. The long-term dynamic monitoring of the distribution of VP1 genotypes is of great public health significance for improving the early warning sensitivity for HFMD.

Key words: Hand, foot and mouth disease, Enterovirus, VP1 gene, Phylogenetic analysis

中图分类号:

R115

关恒云,王春荣,刘岚铮,赵怀龙,白爱英,姜慧钰,董华,李娜,单晓英,成洪旗. 济南市2012~2017年手足口病4种优势肠道病毒阳性及VP1基因型分布[J]. 山东大学学报 (医学版), 2021, 59(5): 60-67.

Hengyun GUAN,Chunrong WANG,Lanzheng LIU,Huailong ZHAO,Aiying BAI,Huiyu JIANG,Hua DONG,Na LI,Xiaoying SHAN,Hongqi CHENG. Positive distribution of four dominant enteroviruses associated with hand, foot and mouth disease and VP1 genotypes in Jinan, China, 2012-2017[J]. Journal of Shandong University (Health Sciences), 2021, 59(5): 60-67.

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年份	病例数	性别		年龄(中位数)(岁)	阳性检出数[n(%)]				χ²	P
年份	病例数	男	女	年龄(中位数)(岁)	EV-A71	CV-A16	CV-A6	CV-A10	χ²	P
2012	859	515	344	0.3~44(3.0)	203(23.6)	368(42.8)	15(1.7)	39(4.5)	631.493^a	< 0.001
2013	848	489	359	0.2~21(3.0)	289(34.1)	148(17.5)	164(19.3)	12(1.4)	306.820^a	< 0.001
2014	935	545	390	0.3~23(3.0)	223(23.9)	357(38.2)	125(13.4)	62(6.6)	325.238^a	< 0.001
2015	756	453	303	0.3~30(3.1)	219(29.0)	82(10.8)	281(37.2)	5(0.7)	401.888^a	< 0.001
2016	741	433	308	0.1~30(3.0)	88(11.9)	372(50.2)	66(8.9)	30(4.0)	656.183^a	< 0.001
2017	790	467	323	0.1~30(3.0)	326(41.3)	66(8.4)	188(23.8)	2(0.3)	516.410^a	< 0.001

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