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马建敏, 黄学勇, 吴妮莉. 手足口病常规检测方法改进分析[J]. 中国公共卫生, 2013, 29(5): 754-757. DOI: 10.11847/zgggws2013-29-05-48
引用本文: 马建敏, 黄学勇, 吴妮莉. 手足口病常规检测方法改进分析[J]. 中国公共卫生, 2013, 29(5): 754-757. DOI: 10.11847/zgggws2013-29-05-48
MA Jian-min, HUANG Xue-yong, WU Ni-li. Improvement and analysis of routine detection method for hand,foot and mouth disease[J]. Chinese Journal of Public Health, 2013, 29(5): 754-757. DOI: 10.11847/zgggws2013-29-05-48
Citation: MA Jian-min, HUANG Xue-yong, WU Ni-li. Improvement and analysis of routine detection method for hand,foot and mouth disease[J]. Chinese Journal of Public Health, 2013, 29(5): 754-757. DOI: 10.11847/zgggws2013-29-05-48

手足口病常规检测方法改进分析

Improvement and analysis of routine detection method for hand,foot and mouth disease

  • 摘要: 目的 为提高RT-PCR的检出水平,进一步改进手足口病的检测方法提供参考依据。方法 同时采用RT-PCR和real-time RT-PCR方法检测2011年2—5月河南省新乡市各级医院临床诊断为手足口病患者的100份粪便标本及50份非肠道病人粪便标本中肠道病毒通用型(PE)、柯萨奇病毒A组16型(CVA16)和肠道病毒71型(EV71)核酸;改进引物,RT-PCR检测CVA16;在NCBI中对RT-PCR使用的各组引物进行BLAST比对,并使用Primer Premier 6.0及Oligo 6.62软件分析各引物。结果 Real-time RT-PCR法检出CVA16、EV71和PE阳性率分别为36%、33%和71%,常规RT-PCR法分别检出20%、27%和64%,2者的PE、EV71检出率无统计学差异,而CVA16 的检出率差异有统计学意义(χ2=6.349,P<0.05);改进引物后,RT-PCR法CVA16阳性检出率提高到35%(χ2=5.643,P<0.05),与临床诊断的符合率增加10%,接近real-time RT-PCR检测水平;2种方法的特异性、漏诊率及误诊率无明显差异。结论 常规RT-PCR法对CVA16的检出率较低,采用改进后的引物,其检出率达到real-time RT-PCR水平。

     

    Abstract: Objective To designe and use new primers in the detection of pan-enterovirus(PE),coxsackievirus A16(CVA16) and enterovirus 71(EV71) for the diagnosis of hand,food and mouth disease(HFMD) using both reverse transcription-PCR(RT-PCR) and real-time RT-PCR.Methods Both RT-PCR and real-time RT-PCR were performed for the detection of PE,CVA16 and EV71 in 100 stool specimens from cases of HFMD and 50 normal control samples.The primers were refined to reexamine CVA16 in RT-PCR.The specificity of primers was checked with Basic Local Aligment Search Tool(BLAST) of National Center and analyzed with Primer Premier 6.0 and Oligo 6.62.Results The positive rates of the samples were 36%,33%,71% and 20%,27%,64% for CVA16,EV71 and PE with real-time RT-PCR and RT-PCR assays,respectively.Except CVA16,no significant difference was found in the detection rates of PE or EV71 between the two methods.The utilization of refined primers in RT-PCR could significantly increase the positive rate for CVA16 up to 35%(P<0.05),and the coincidence rate with clinic diagnosis increased by 10%,which was close to that of real-time RT-PCR assay.There were no significant differences between the two methods in specificity,misdiagnosis rate and missed diagnosis rate.Conclusion Routine RT-PCR method has a low sensitivity in detectoin of CVA16 and the detection rate could be increased to the level of real-time RT-PCR with newly designed primers.

     

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