不同肠道病毒感染手足口病患儿病毒载量及临床特征对比分析

发布时间：2018-04-01 11:27

  本文选题：手足口病　切入点：肠道病毒属　出处：《中国全科医学》2016年18期

【摘要】：目的对比分析肠道病毒71型(EV71)与柯萨奇A组16型(Cox A16)感染手足口病(HFMD)患儿的病毒载量及临床特征。方法收集2015年5—9月唐山市妇幼保健院儿科确诊的HFMD患儿430例,根据临床症状、体征和病毒种类将患儿分为EV71轻度组162例、EV71重度组87例、Cox A16轻度组158例、Cox A16重度组23例。采用实时荧光定量反转录PCR技术检测患儿咽拭子EV71、Cox A16 RNA,计算病毒载量;记录患儿的病程、体温、热程、口腔溃疡、流涎、咳嗽、手部出疹、足部出疹、嗜睡、惊厥、呕吐、意识改变、肢体抖动、肌痉挛情况。结果标准曲线显示循环阈值(Ct值)与病毒载量的对数呈高度负相关(r=-1.000,P0.01)。Ct值(X)与病毒载量的对数(Y)的关系为Y=-0.29X+13.03。Cox A16轻度组、Cox A16重度组HFMD患儿Ct值较EV71轻度组、EV71重度组降低(P0.05);EV71轻度组与EV71重度组、Cox A16轻度组与Cox A16重度组HFMD患儿Ct值比较,差异无统计学意义(P0.05)。EV71重度组、Cox A16重度组HFMD患儿病程较EV71轻度组、Cox A16轻度组延长(P0.05);EV71重度组HFMD患儿病程较Cox A16重度组延长(P0.05)。4组HFMD患儿体温≥38.5℃、口腔溃疡、流涎、手部出疹、足部出疹发生率比较,差异均无统计学意义(P0.05)。EV71重度组、Cox A16重度组HFMD患儿热程≥3 d发生率较EV71轻度组、Cox A16轻度组升高(P0.007);EV71重度组、Cox A16重度组HFMD患儿体温≥38.5℃+热程≥3 d发生率较EV71轻度组、Cox A16轻度组升高,EV71轻度组HFMD患儿体温≥38.5℃+热程≥3 d发生率较Cox A16轻度组升高,EV71重度组HFMD患儿体温≥38.5℃+热程≥3 d发生率较Cox A16重度组升高(P0.007);Cox A16轻度组、Cox A16重度组HFMD患儿咳嗽、手部出疹数≥15个(双手)、足部出疹数≥15个(双足)发生率较EV71轻度组、EV71重度组升高(P0.007)。EV71重度组、Cox A16重度组HFMD患儿嗜睡、呕吐发生率较EV71轻度组升高,EV71重度组HFMD患儿嗜睡发生率较Cox A16重度组升高(P0.01)。结论 HFMD患儿病毒载量与感染病毒相关,但不同病情程度间病毒载量无差别。不同病毒感染及病情程度患儿间热程≥3 d、体温≥38.5℃+热程≥3 d、咳嗽、手部出疹数≥15个(双手)、足部出疹数≥15个(双足)、嗜睡、惊厥、呕吐、意识改变、肢体抖动、肌阵挛发生率有差异。
[Abstract]:Objective to compare the viral load and clinical characteristics of children with HFMD infected by enterovirus 71 (EV71) and coxsackie group A (Coxsackie A). Methods 430 children with HFMD diagnosed in Tangshan Maternal and Child Health Hospital from May to September 2015 were collected according to their clinical symptoms. The children were divided into two groups: EV71 mild group (n = 162), severe group (n = 87), mild group (n = 158), severe group (n = 23). Real-time fluorescence quantitative reverse transcription (PCR) technique was used to detect the RNA of pharyngeal swab EV71 EV71 A16, and to calculate the viral load. The course of disease, body temperature, fever, oral ulcer, salivation, cough, hand rash, foot rash, somnolence, convulsion, vomiting, consciousness change, limb jitter were recorded. Myospasm. Results the standard curve showed that the circulating threshold value (Ct) was negatively correlated with the logarithm of viral load (P 0.01N. Ct) and the logarithm of viral load. The relationship between the value of Ct and the number of viral loads was that the Ct value of HFMD in severe 13.03.Cox A16 group was lighter than that in severe 13.03.Cox A16 group. The levels of HFMD Ct in patients with severe Cox A16 and severe Cox A16 were compared with those of mild group and severe group of EV71, and the value of HFMD was decreased in severe group of Cox A16 and mild group of EV71, compared with that of severe group of Cox A16. There was no significant difference in the course of disease of HFMD children in severe group P0.05N. EV71 compared with EV71 mild group. The course of disease in HFMD group was longer than that in Cox A16 group. The course of disease was more than 38.5 鈩，

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