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目的对2007-2010年云南省急性迟缓性麻痹(acute flaccid paralysis,AFP)病例和健康儿童中非脊灰肠道病毒(non-polio enterovirus,NPEV)的分离情况进行比较,分析引起AFP的主要病原并对分离到的病毒基因特征进行分析。方法对云南省2007-2010年AFP病例粪便样本和<15岁健康儿童粪便样本进行病毒分离和基因测序定型,对两类人群中的病毒分离状况进行比较。结果 2007-2010年共从931例AFP病例粪便样本中检测到NPEV 63株,分离率为6.8%(63/931),其中肠道病毒A组(enterovirus A,EV-A)12株,占19.1%(12/63),肠道病毒B组(EV-B)46株,占73.0%(46/63),肠道病毒C组(EV-C)5株,占7.9%(5/63);从1 256份健康人群粪便样本中分离到NPEV 115株,分离率为9.2%(115/1256),其中EV-A 5株,占4.4%(5/115),EV-B 101株,占87.8%(101/115),EV-C 9株,占7.8%(9/115);在两组人群中均未分离到肠道病毒D组(EV-D)病毒。对两组人群中常见病毒的基因进化分析表明,这些病毒具有基因多样性特点。结论云南省2007-2010年连续4年的监测表明,AFP病例中EV-A组病毒和EV-C的分离率(19.1%和7.9%)均高于健康人群(4.3%和7.8%),而健康人群中EV-B组病毒阳性率(87.8%)高于AFP病人(73.0%),EV-A组病毒和EV-C组病毒可能是引起AFP的主要病原。基因进化分析表明,云南省EV-B组病毒中的某些病毒可分为2~5个不同的进化分支(Cluster),具有基因多样性特点。
Objective To compare the isolation of non-polio enterovirus (NPEV) between acute flaccid paralysis (AFP) cases and healthy children in Yunnan Province from 2007 to 2010. The main pathogens causing AFP The characteristics of the isolated virus genes were analyzed. Methods Stool samples of AFP cases and stool samples of healthy children aged <15 years from 2007 to 2010 in Yunnan province were isolated and sequenced. The virus isolation in two groups of people was compared. Results A total of 63 strains of NPEV were isolated from 931 stool samples of AFP from 2007 to 2010, and the isolation rate was 6.8% (63/931). Among them, 12 strains of enterovirus A (EV-A) accounted for 19.1 46 strains of Escherichia coli (EV-B) accounted for 73.0% (46/63) and 5 strains of EV-C (7.9% (5/63) 115 strains of NPEV were isolated from stool samples of 1 256 healthy people, the isolation rate was 9.2% (115/1256), including 5 strains of EV-A, accounting for 4.4% (5/115) and 101 strains of EV-B 87.8% (101/115) and 9 strains of EV-C, accounting for 7.8% (9/115). No enterovirus D (EV-D) virus was isolated from the two populations. Genetic analysis of common viruses in both groups showed that these viruses are characterized by genetic diversity. Conclusion The surveillance of Yunnan Province for four consecutive years from 2007 to 2010 showed that the isolation rate of EV-A virus and EV-C in AFP cases (19.1% and 7.9%) were higher than those in healthy people (4.3% and 7.8%), respectively The positive rate of EV-B virus in healthy population (87.8%) was higher than that in AFP patients (73.0%). The EV-A and EV-C viruses were the main pathogens causing AFP. Genetic evolution analysis shows that some viruses in EV-B group of Yunnan province can be divided into 2 ~ 5 different evolutionary clusters (Cluster), which has the characteristics of gene diversity.