手足口病住院患儿的病原学和临床特征

发布时间：2018-05-29 21:00

本文选题：手足口病 + 荧光PCR　；参考：《中国感染控制杂志》2017年11期

【摘要】：目的了解手足口病(HFMD)病原体分布情况及流行趋势,为HFMD的防治提供依据。方法调查2015年1—12月某院确诊的HFMD住院患儿,采用实时荧光PCR法对HFMD病例标本进行肠道病毒(EV)通用型、肠道病毒71(EV71)型和柯萨奇A16(CoxA16)型核酸检测。分析不同月份、性别、年龄组、感染类型患儿EV阳性检出率及各型别分布情况。结果 2015年共采集837例HFMD患儿咽拭子标本,其中EV阳性标本380份,阳性率为45.40%。病毒分型结果显示:EV71阳性标本110例(28.95%);CoxA16阳性标本7例(1.84%);EV71+CoxA16阳性标本6例(1.58%);其他EV阳性标本257例(67.63%)。该病从4月份开始进入高发期,5~6月达到最高峰,7~12月持续高发。不同月份患儿EV阳性检出率比较,差异有统计学意义(P0.05)。发病年龄主要集中在3岁以下儿童。不同年龄组患儿EV阳性检出率、EV各型别构成比较,差异均有统计学意义(均P0.05)。重症HFMD病例的EV阳性检出率为65.34%,高于普通病例的27.06%(P0.001)。EV71型感染患儿中重症病例比率为90.00%;由其他EV感染所致的患儿中重症病例比率为60.70%;EV71+CoxA16双重感染的患儿全部为重症病例。不同感染类型患儿EV各型别构成比较,差异有统计学意义(P0.001)。结论 2015年该院收治的HFMD住院患儿的EV感染型别主要以非EV71、非CoxA16的其他EV为主,对高发季节、3岁以下的高发人群及重症病例应高度关注,做好预防和治疗工作。
[Abstract]:Objective to investigate the distribution and epidemic trend of HFMD in HFMD and to provide evidence for the prevention and treatment of HFMD. Methods We investigated the hospitalized children with HFMD diagnosed in a hospital from January to December 2015, and detected the nucleic acid of enterovirus (EV), enterovirus 71 (EV71) and coxsackie A16 CoxA16 (Coxsackie A16 CoxA16) by real-time fluorescence PCR method. The positive detection rate and distribution of EV in different month, sex, age group and infection type were analyzed. Results in 2015, a total of 837 pharyngeal swabs of HFMD children were collected, of which 380 were EV positive, with a positive rate of 45.40b. The results of virus typing showed that there were 110 positive specimens of EV71 and 7 positive specimens of CoxA16. There were 6 positive specimens of EV71 CoxA16 in 6 cases and 67.6363 cases of other EV positive specimens. The disease began to enter a high incidence period from April to June and reached its highest peak from July to December. The positive rates of EV in different months were significantly different (P 0.05). The age of onset was mainly in children under 3 years of age. The positive detection rate of EV in different age groups was significantly different (P < 0.05). The positive rate of EV in severe HFMD cases was 65.34, which was higher than that in normal cases with 27.06%(P0.001).EV71 type infection was 90.000.The ratio of severe cases caused by other EV infections was 60.70% and that of children with EV71 CoxA16 double infection was all severe cases. There were significant differences in the types of EV among different infection types (P 0.001). Conclusion in 2015, the main types of EV infection in hospitalized children with HFMD were non-EV71, and other EV of non-EV. it is necessary to pay close attention to the high incidence population and severe cases under 3 years of age in high incidence season, and do well in the prevention and treatment of EV71.ConclusionThe main types of EV infection are non-EV71and non-EV71.
【作者单位】：株洲市中心医院;
【分类号】：R725.1

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