北京地区柯萨奇病毒A组6型、肠道病毒EV71型和柯萨奇病毒A组16型手足口病流行特征及临床特点比较

发布时间：2018-12-10 18:07

【摘要】：目的了解柯萨奇病毒A组6型、肠道病毒71型和柯萨奇A组16型手足口病流行特征、临床特点,为指导临床诊断,调整手足口病防控策略提供科学依据。方法采用前瞻性调查的方法,采集2013年8月至2015年9月在北京市儿童医院诊断的手足口病临床确诊病例的咽拭子,将手足口病原核酸检测阳性的病例分为CA6、EV71、CA16 3组,分析比较3组的临床特点、流行特征、预后及影响因素。结果共采集HFMD临床诊断病例574例患儿咽拭子,CA6入组122例,EV71入组107例,CA16入组124例。13组年龄、性别分布一致,差异无统计学意义。2不同年份流行主要毒株不同,但3种病原体引起的手足口病高峰均在夏季。3CA6组发热比例高达78.69%,明显高于EV71组(35.51%)和CA16组(37.90%)(P0.001),平均体温约为38.78℃。CA6组表现大疱疹(9.01%)、结痂(8.20%)、皮疹部位疼痛(29.51%)、恢复期脱皮(38.52%)、脱甲(35.25%)、色素沉着(11.47%)比例高于EV71组、CA16(P0.001)。43组在卫生学指标方面差异无统计学意义。结论CA6、EV71和CA16感染所致的HFMD发病高峰季节一致;与EV71、CA16感染相比,CA6感染引起的高热比例较高,部分病例可表现为大疱疹,疼痛、脱皮、脱甲、色素沉着、结痂发生率高,预后较好。
[Abstract]:Objective to investigate the epidemic characteristics and clinical characteristics of coxsackievirus A group 6, enterovirus 71 and coxsackie A group 16 hand, foot and mouth disease, and to provide scientific basis for guiding clinical diagnosis and adjusting prevention and control strategy of hand, foot and mouth disease. Methods the pharyngeal swabs of clinically diagnosed HFMD cases diagnosed in Beijing Children's Hospital from August 2013 to September 2015 were collected by prospective investigation. The patients with HFMD were divided into three groups: CA6,EV71,CA16 group. The clinical characteristics, epidemic characteristics, prognosis and influencing factors of the three groups were analyzed and compared. Results throat swabs of 574 children with HFMD were collected, including 122 cases of CA6, 107 cases of EV71 and 124 cases of CA16. However, the peak of HFMD caused by the three pathogens occurred in summer. The febrile rate in 3CA6 group was 78.69, which was significantly higher than that in EV71 group (35.51%) and CA16 group (37.90%) (P0.001). The average body temperature was about 38.78 鈩，

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