柯薩奇病毒A組6型手足口病并發脫甲癥的相關因素及基因分析

滕淑　　趙仕勇　　陳海哨　　宋聞　　黃笑笑　　蔣茂瑩　　林先耀

[關鍵詞] 手足口病;柯薩奇病毒感染;脫甲;基因型

[中圖分類號] R181.2? ? ? ? ? [文獻標識碼] A? ? ? ? ? [文章編號] 1673-9701（2021）21-0005-06

Analysis of related factors and gene of Coxsackie virus group A type 6 HFMD complicated with onychomadesis

TENG Shu? ?ZHAO Shiyong? ?CHEN Haishao? ?SONG Wen? ?HUANG Xiaoxiao? ?JIANG Maoying? ?LIN Xianyao

Department of Pediatric Infectious Diseases， Hangzhou Children′s Hospital， Hangzhou? ?310014，China

[Abstract] Objective To understand the related factors of Coxsackie virus group A type 6 （CA6） hand-foot-mouth disease （HFMD） complicated with onychomadesis， and analyze the genetic characteristics of CA6， so as to provide scientific basis for clinical diagnosis and treatment， and developing prevention and control measures. Methods A total of 59 children with CA6 HFMD who were hospitalized in Hangzhou Children′s Hospital from September 2017 to June 2018 were collected for a follow-up study on their onychomadesis.And 15 children were randomLy selected for CA6 VPl gene sequencing to construct phylogenetic tree for homologous alignment analysis and evolutionary analysis. Results Of the 59 children， 42 were successfully followed up， and 17 were lost to follow-up， with a loss to follow-up rate of 28.8%. Of the 42 children who were successfully followed up， 16 cases （38.1%） had onychomadesis， and 26 cases （61.9%） had none. The mean time of CA6 children patients was （32±9）days after acute infection. No significant differences were observed in the viral load， immunoglobulin G， immunoglobulin A，immunoglobulin M， T lymphocyte proportions， helper T cell proportions， inhibitory/cytotoxic T cell proportions， B lymphocyte proportions， NK cell proportions between the onychomadesis group and the non-onychomadesis group（P>0.05）. The homology comparison and evolutionary analysis of CA6 VPl gene showed that the nucleotide homology of 15 CA6 gene sequences was 91.1% to 99.9%， among which 3 were C genotype and the other 12 were D3 genetic subtype. Conclusion In children with CA6 HFMD， onychomadesis is more common in the 5th week after onset. The occurrence of onychomadesis has nothing to do with the viral load of the children. The CA6 strain in this study belongs to C genotype and D3 genetic subtype， of which D3 genetic subtype is the dominant type.

[Key words] Hand-foot-mouth disease （HFMD）; Coxsackie virus infection; Onychomadesis; Genotype