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目的 本研究旨在系统评估2023-2024年西藏自治区健康儿童肠道病毒（Enterovirus,EV）的流行特征，为区域性病毒监测和疾病预防提供依据。方法 本研究纳入456份健康儿童粪便样本进行分析，通过实时荧光聚合酶链反应（Real-time reverse-transcription polymerase chain reaction,real-time RT-PCR）进行EV筛查，采用逆转录PCR对阳性样本扩增并测序VP1区，并对测定的序列进行分子分型及系统发育分析。结果 EV总体检出率为21.71%(99/456)，分属Enterovirus alphacoxsackie、Enterovirus betacoxsackie和Enterovirus coxsackiepol，其中Enterovirus betacoxsackie占比最高（54.55%,54/99）。主要检出血清型包括Coxsackievirus A4(CVA4,26/99,26.26%)、Coxsackievirus B5(CVB5,23/99,23.23%)、Coxsackievirus B4(CVB4,14/99,14.14%)、Coxsackievirus B2(CVB2,10/99,10.10%)及Poliovirus type 3(PV3,9/99,9.09%)等。EV感染集中于3–5岁儿童阶段，性别差异无统计学意义。地区分布结果表明，拉萨市检出的EV型别最为丰富，日喀则及阿里地区以CVA4和CVB组为主，山南市CVB5型比例最高。系统发育分析显示，西藏自治区分离的CVB2、CVB4和CVB5均属各自血清型的D基因型，与国内外流行株具有较近系统进化关系。结论 本研究揭示了2023–2024年西藏自治区EV的流行现状，结合2020-2022的既往监测数据，发现CVB组病毒活跃度有所抬升，亟需对该地区CVB组病毒进行持续性监测和应对性防控。
Abstract：Objective This study aimed to systematically assess the epidemiological characteristics of enteroviruses(EV) among healthy children in the Xizang Autonomous Region,China during 2023 – 2024, providing a basis for regional viral surveillance and disease prevention.Methods A total of 456 fecal samples from healthy children were analyzed, and EV screening was performed using real-time reverse-transcription polymerase chain reaction(real-time RT-PCR). The VP1 region of EV-positive samples was amplified and sequenced by RT-PCR, followed by molecular typing and phylogenetic analysis of the obtained sequences.Results The overall EV detection rate was 21.71%(99/456). Detected viruses were classified into Enterovirus A(EV-A), Enterovirus B(EV-B), and Enterovirus C(EV-C), among which EV-B predominated, accounting for(54.55%, 54/99) of positive samples. The most frequently detected serotypes were Coxsackievirus A4(CVA4, 26/99, 26.26%), Coxsackievirus B5(CVB5, 23/99, 23.23%), Coxsackievirus B4(CVB4, 14/99, 14.14%), Coxsackievirus B2(CVB2, 10/99, 10.10%), and poliovirus type 3(PV3, 9/99, 9.09%). EV infections were mainly observed in children aged 3 – 5 years, with no statistically significant difference between sexes. Regional analysis indicated that Lhasa exhibited the greatest diversity of EV serotypes, while CVA4 and CVB serotypes predominated in Shigatse and Ngari, and CVB5 was most prevalent in Shannan. Phylogenetic analysis showed that CVB2, CVB4, and CVB5 isolates from the Xizang Autonomous Region all belonged to genotype D of their respective serotypes and were closely related to contemporary strains circulating both domestically and internationally. Conclusion This study delineates the epidemiological profile of EVs among healthy children in the Xizang Autonomous Region during 2023– 2024. When combined with surveillance data from 2020 – 2022, a notable increase in the circulation intensity of Coxsackievirus B was observed, underscoring the need for sustained continuous surveillance and targeted prevention and control measures for CVB in this region.
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基本信息:
DOI：10.13242/j.cnki.bingduxuebao.250371
中图分类号:R512.5
引用信息:
[1]邵珂欣,红梅,肖梦怡,等.2023–2024年西藏自治区健康人群肠道病毒监测：柯萨奇B组病毒流行强度上升[J].病毒学报,2026,42(01):51-59.DOI:10.13242/j.cnki.bingduxuebao.250371.
基金信息:
国家疾病预防控制局公共卫生人才培养支持项目（项目号：GJJKJ-2024-ZY）; 传染病溯源预警与智能决策全国重点实验室（NITFID）资助项目（项目号：ZDGWNLJS25-36）,题目：未知及新发病原体监测及预测预警技术研究; 国家重点研发计划项目（项目号：2021YFC2302003）,题目：病毒监测网络数据标准及数据平台建设~~