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目的了解影响实验室手足口病毒检出的因素,分析秦皇岛市2009~2010年手足口病例肠道病毒核酸的检测情况。方法应用实时荧光PCR技术对可疑手足口病例送检的咽拭子、肛试子、疱疹液等样本中肠道病毒71型(EV71)、柯萨奇病毒A组16型(CoxA16)、肠道病毒通用型(EV)进行病原学检测。结果 307例可疑病例中肠道病毒检出率为69.38%,样本的不同来源和存在的不同状态都对结果的检出有影响;秦皇岛市手足口发病集中在5~7月份,男女性别比为2.04:1,以5岁以下儿童为主;EV71与其他病毒所致重症手足口之比为12.5:1差异有统计学意义(χ2=18.86,P<0.05)。结论切实加强实验室肠道病毒核酸检测工作,从多方面提高病毒检出的敏感性和特异性;EV71型是引起手足口重症病例的主要毒株,实时荧光PCR法可以快速检测手足口病样本中的肠道病毒核酸,为临床诊断和流行病防控提供病原学依据。
Objective To understand the factors influencing the detection of hand, foot and mouth virus in laboratories and to analyze the detection of enterovirus nucleic acid in hand, foot and mouth cases from 2009 to 2010 in Qinhuangdao. Methods Real-time fluorescence PCR was used to detect EV71, CoxA16, intestinal tract of intestinal tract in samples of throat swab, anal test, Virus universal (EV) for pathogenic detection. Results The detection rate of enterovirus in 307 suspicious cases was 69.38%. Different sources of samples and different status existed influence the detection of the results. The incidence of HFMD in Qinhuangdao City was from May to July. The sex ratio of male to female was 2.04: 1, mainly children under 5 years of age; EV71 and other viruses caused by severe hand-foot mouth ratio of 12.5: 1 difference was statistically significant (χ2 = 18.86, P <0.05). Conclusion The detection of laboratory enterovirus nucleic acid is effectively strengthened and the sensitivity and specificity of virus detection are improved in many aspects. The EV71 type is the major strain that causes severe cases of hand, foot and mouth disease. Real-time fluorescence PCR can rapidly detect HFMD samples Enteric virus nucleic acid in clinical diagnosis and epidemiology provide etiological basis.