石家庄市2009—2012年手足口病病原学特征及变化规律分析

发布时间：2018-05-26 01:24

本文选题：手足口病 + 病原　；参考：《中国全科医学》2014年35期

【摘要】：目的分析2009—2012年石家庄市手足口病(HFMD)病原体分布特征及规律。方法选择石家庄市2009—2012年临床诊断为HFMD的部分普通及所有聚集发病、重症和死亡病例,采集病例咽拭子、肛拭子或疱疹液、便等生物学标本进行病原学检测。结合地理信息系统(GIS)对监测数据进行空间分布分析。结果 4年共采集3 842例HFMD病例生物学标本,阳性检出率为69.29%(2 662例)。其中人类肠道病毒71型(EV71)、柯萨奇病毒(Cox)A16和其他肠道病毒比例分别占50.60%(1 347例)、35.05%(933例)和14.35%(382例)。2009—2012年,石家庄市各年份HFMD病原学构成间差异有统计学意义(χ2=2.367,P0.001);其中2009年以Cox A16流行为主(占56.46%),2010、2011年以EV71流行为主(占77.34%、57.51%),2012年再次以Cox A16流行为主(占66.40%)。4年中各型病原在4或5月阳性检出数最高,6月开始迅速下降。Cox A16基本呈单峰变化,而EV71后期会再次增多,呈现"拖尾"现象;其他肠道病毒检出例数较少,时间分布特征不明显。同一流行年各县区病原分布存在地区差异;0~岁儿童较易感染EV71;EV71感染者中重症病例所占比例明显高于普通病例,死亡病例均由EV71感染引起。结论石家庄市近4年来HFMD病原学构成有变化,呈现Cox A16与EV71交替成为优势病原的现象。EV71、Cox A16及其他肠道病毒分别呈现多峰、单峰和不显著峰的时间分布特征。在同一流行年,多数县区的优势病原与全市一致,个别县区的优势病原与全市不一致。随着年龄增长,EV71阳性检出构成比逐渐降低,Cox A16阳性检出构成比逐渐增多,其他肠道病毒构成比变化不大。
[Abstract]:Objective to analyze the distribution of HFMDs in Shijiazhuang from 2009 to 2012. Methods some common, severe and dead cases diagnosed as HFMD in Shijiazhuang from 2009 to 2012 were selected. Pharynx swabs, anal swabs or herpes fluid were collected for pathogen detection. The spatial distribution of monitoring data is analyzed with GIS. Results 3 842 biological specimens of HFMD were collected in 4 years, and the positive rate was 69. 29% and 26 62 cases respectively. Among them, human enterovirus 71 (EV71), Coxsackie virus (CoxA16) and other enteric viruses accounted for 50.606 / 1 347 cases and 35.05 / 933 cases respectively) and 14.3535 / 382 cases for 2009-2012, respectively. In Shijiazhuang City, there were significant differences in the etiological composition of HFMD in different years (蠂 ~ 22.367 ~ (7) P 0.001), in which Cox A16 was predominant in 2009 (56.46%), EV71 in 2011 (77.34 4), and Cox A16 in 2012 (66.40%). In 4 or 5 years, the prevalence of Cox A16 was found in 4 or 5 years. The monthly positive rate was the highest, and began to decline rapidly in June. Cox A16 showed a unimodal change. In the latter stage of EV71, the number of cases of other enterovirus was less, and the time distribution was not obvious. In the same epidemic year, the proportion of severe cases of EV71 infected children was higher than that of common cases, and the death cases were caused by EV71 infection. Conclusion the etiological composition of HFMD has changed in recent four years in Shijiazhuang city, showing that Cox A16 and EV71 are the dominant pathogens alternately. EV71Cox A16 and other enterovirus show multi-peak, single-peak and unsignificant peaks, respectively. In the same epidemic year, the dominant pathogens of most counties and districts were the same as that of the whole city, while the dominant pathogens of individual counties and districts were not the same as that of the whole city. With the increase of age, the positive ratio of EV71 was decreased gradually, and the ratio of positive detection of Cox A16 increased gradually, but the ratio of other enterovirus did not change.
【作者单位】：北京市大兴区疾病预防控制中心;河北北方学院;石家庄市疾病预防控制中心;
【基金】：中华预防医学会“公共卫生应用研究与疫苗可预防疾病科研资金”支持项目(20100303) 河北省卫生厅科研基金项目(20120179)
【分类号】：R725.1;R181.3

【参考文献】