广州地区健康儿童肠道病毒71型抗体水平调查

目的调查广州地区健康儿童肠道病毒71型抗体IgG（EV71-IgG）的水平,分析与EV71所致手足口病（HFMD）发病的关系。方法以来源于广州市妇女儿童医疗中心（我院）中心实验室分离到的EV71 C4亚型标本,制备EV71诊断抗原,建立EV71-IgG抗体诊断试剂盒方法,并进行实验室评价。收集2010年1~3月在我院儿保科抽血进行常规保健检测的标本,筛选出无发热、无HFMD症状的健康儿童血清标本,检测EV71-IgG抗体。选取我院2010年全年门诊及住院HFMD患儿的咽拭子标本进行EV71特异性核酸检测。结果①本研究建立的试剂盒EV71-IgG抗体检测临界值为0.148;与细胞中和实验方法阳性符合率为100%,阴性符合率为92%,与柯萨奇A16病毒抗体无交叉反应。②819名健康儿童血清标本中,男481名,女338名。〈1岁组（60%,60/100名）和~2岁组（39.3%,72/183名）EV71-IgG抗体阳性率显著高于其他各年龄组~3岁、~4岁、~5岁和~14岁组分别为12.9%（15/116名）、27.1%（38/140名）、14.2%（16/113名）和22.8%（38/167名）]。EV71-IgG抗体阳性率无显著性别差异。③4 780例EV71阳性HFMD患儿中,男3 070例,女1 718例。〈1岁310例（6.5%）,~2岁1 157例（24.2%）,~3岁1 337例（28.0%）,~4岁1 094例（22.9%）,~5岁450例（9.4%）,~14岁432例（9.0%）。④各年龄组EV71-IgG抗体阳性率与EV71阳性年龄构成比呈相反趋势,〈1岁组EV71-IgG抗体阳性率最高,EV71阳性年龄构成比最低;~3岁组EV71-IgG抗体阳性率最低,EV71阳性年龄构成比最高。结论 〈1岁健康儿童EV71-IgG阳性率最高,EV71阳性年龄构成比与EV71-IgG阳性率呈相关现象。

Investigation on enterovirus 71 antibody levels among children in Guangzhou area

Objective To investigate the levels of the enteroovirus 71 and C4 genetype antibody（EV71-lgG） among children in Guangzhou area,and the relationship between EV71-IgG and hand,foot and mouth disease（HFMD）.Methods EV71 diagnostic antigen was prepared from EV71 C4 genotype samples isolated from children with HFMD in Children＇s Hospital,Guangzhou Women and Children＇s Medical Center to establish the method of diagnostic EV71-IgG kits and laboratory evaluation.Blood samples of healthy children confirmed to be without fever and symptoms of HFMD by physical examinations in our hospital were collected from January to March in 2010 to be tested for EV71-IgG antibody.Swab specimens were collected from outpatient and inpatient children with HFMD in our hospital in 2010 to be tested for specific EV71 nucleic acid.Results ① The cut-off value of kit established by our laborary was 0.148.Compared with the cell neutralization tests,the accordancy rate was 100% for positive rate and 92% for negative rate.There was no cross reaction with Coxsackie A16 virus antibody.②Serum samples were from 819 healthy children,including 481 males and 338 females.EV71-IgG positive rate in children aged under 1 year was the highest（60%,60/100）,and EV71-IgG positive rates of-2-year-old,-3-year-old,-4-year-old,-5-year-old and-14-year-old groups were 39.3%（72/183）,12.9%（15/116）,27.1%（38/140）,14.2%（16/113） and 22.8%（38/167）.There was no significant difference between different genders.③ A total of 4 780 children with positive EV71 were enrolled,including 3 070 males and 1 718 females.There were 310（6.5%） children in 1-year-old group,1 157（24.2%） in-2-year-old,1 337（28.0%） in-3-year-old,1 094（22.9%） in-4-year-old,450（9.4%） in-5-year-old,432（9.0%） in-14-year-old groups.④ In each group EV71-IgG antibody positive rate was opposite to the tendency of EV71 positive rate.In 1-year-old group,EV71-IgG positive rate was the highest while EV71 positive rate was the lowest.In-3-year-old group,EV71-IgG positive rate was the lowest while EV71 positive rate was the highest.Conclusions In Guangzhou area,EV71-IgG positive rate in children aged under 1 year was the highest.EV71 positive rate was significantly associated with EV71-IgG positive rate.