摘要目的 分析2013-2017年沈阳市手足口病肠道病毒病原谱特征与流行病学特点.方法 收集2013-2017年沈阳市手足口病标本,应用荧光定量PCR方法对EV71型、Cox A16型、Cox A6型和Cox A10型肠道病毒进行检测,然后对肠道病毒阳性的其他标本应用传统RT-PCR方法针对VP1全长基因进行扩增,比对分析确认型别,并对Cox A6的VP1全基因序列进行系统进化分析.结果 沈阳地区2013-2017年间共收集2 881份标本,肠道病毒检测阳性率为71.71％ (2 066/2 881),各年间阳性率差异有统计学意义(x2=50.62,P＜0.01).共检测出EV71、Cox A6、Cox A16、Cox A10、Cox A4、Cox A2、Cox A12、Cox A5、Cox B2、Cox A8、Cox A9、Cox B3、E9、E16和脊髓灰质炎病毒3型等15种型别的肠道病毒.进化分析表明,沈阳地区CoxA6型毒株主要位于D3a分支上.结论 沈阳地区手足口病主要由EV71型、Cox A6型和Cox A16型3种肠道病毒共同流行引起,Cox A6型肠道病毒已经成为沈阳市仅次于EV71型的第二位病原.

abstractsObjective To understand the pathogenic spectrun and epidemiological characteristics of hand,foot,and mouth (HFMD) in Shenyang city,2013-2017.Methods Samples of HFMD were collected in Shenyang during 2013 to 2017.Enterovirus 71 (EV71),coxsackievirus A (Cox A) 16,Cox A6 and Cox A10 were screened by real time quantitative RT-PCR (reverse transcription-PCR).The complete VP1 genes were amplified by traditional RT-PCR for the samples which were positive only for enterovirus genus.The amplicons were sequenced and the genotypes were confirmed by alignment analysis.The phylogenetic analysis was applied for entire VP1 gene of Cox A6.Resnlts From 2013 to 2017,2 881 samples were collected in Shenyang and the positive rate of enterovirus was 71.71％ (2 066/2 881).The differences of positive rates among years were statistically significant (x2=50.62,P＜0.01).Fifteen types of enterovirus were detected,including EV71,Cox A6,Cox A16,Cox A10,Cox A4,Cox A2,Cox A12,Cox A5,Cox B2,Cox A8,Cox A9,Cox B3,E9,E16 and poliovirus type-3.The Cox A6 isolates from Shenyang during 2013 to 2017 could be classified into the cluster D3a in the phylogenetic tree.Conclusions All three types of enterovirus,EV71,Cox A6 and Cox A16 were responsible for HFMD in Shenyang city.Cox A6 was the second predominant pathogen in Shenyang area.