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目的分析掌握2014年新疆手足口病的病原构成及病原学特征,为手足口病防控策略的制定提供依据。方法采用实时荧光RT-PCR法对全疆各地的手足口病病例样本进行肠道病毒EV-A71、CV-A16核酸检测;选取部分经核酸检测为EV-A71阳性及CV-A16阳性的样本,采用RT-PCR法进行VP1区核酸扩增及基因序列测定,采用ChromasPro1.7.6、BioEdit7.1.9及MEGA6.06等生物分析软件进行核酸序列同源性比较和系统进化分析。结果 1 932例病例样本中检出肠道病毒阳性1 487例,其中EV-A71、CV-A16及其他肠道病毒阳性数分别为444、887和156例,三者的构成比分别为29.9%、59.6%和10.5%;8株EV-A71毒株VP1区核酸序列与C4a亚型参考株同源性最高,为91.8%~93.4%,均属于C4a基因亚型,与2008年安徽阜阳和2007年山东临沂毒株有着最近的亲缘关系。10株CV-A16毒株VP1核酸序列与B1b参考株同源性最高,为93.4%~95.8%,10株毒株均属于B1b基因亚型,但分属于2个不同的分支。结论加强手足口病病原学监测,掌握HFMD的病原特点及重要病原的基因变异变迁规律对手足口病防控工作至关重要。
Objective To analyze and grasp the etiopathogenisis and etiological characteristics of hand, foot and mouth disease in Xinjiang in 2014, and provide basis for the prevention and control strategy of hand-foot-mouth disease. Methods The real-time fluorescent RT-PCR method was used to detect the EV-A71 and CV-A16 nucleic acids in hand, foot-and-mouth disease cases in Xinjiang. Some samples with positive EV-A71 and CV- The nucleic acid amplification and gene sequencing of VP1 region were determined by RT-PCR. The homology comparison and phylogenetic analysis of nucleic acid sequences were carried out using biological analysis softwares such as ChromasPro1.7.6, BioEdit7.1.9 and MEGA6.06. Results A total of 1 487 cases of enterovirus positive were detected in 1 932 cases. The positive numbers of EV-A71, CV-A16 and other enterovirus were 444, 887 and 156, respectively, the proportions of the three were 29.9% , 59.6% and 10.5%, respectively. The VP1 region of 8 strains of EV-A71 had the highest homology with reference strains of C4a subtypes, ranging from 91.8% to 93.4%, all belonging to C4a subtype. Shandong Linyi strain has the closest genetic relationship. The nucleotide sequence of VP1 of 10 strains of CV-A16 had the highest homology with that of B1b, ranging from 93.4% to 95.8%. All 10 isolates belonged to B1b genotype, but belonged to two different branches. Conclusion It is very important to strengthen the prevention and control of hand foot and mouth disease by strengthening the etiological monitoring of hand foot and mouth disease, mastering the pathogenic features of HFMD and the genetic variation and variation of important pathogens.