菏泽地区2009年肠道病毒71型与其他肠道病毒所致手足口病临床差异研究  

Clinical Study of Infant Hand-foot and Mouth Disease Caused by Enterovirus 71 and Other Enterovirus in HeZe

作　　者：钱娜[1] 陈宗波[1] 刘清华 张全发 刘相萍[1] 隋爱华[1] 赵娜[1] 陈真真[1] 

机构地区：[1]青岛大学医学院附属医院,山东青岛266003 [2]成武县人民医院,山东成武371723

出　　处：《现代生物医学进展》2009年第24期4725-4728,共4页Progress in Modern Biomedicine

基　　金：山东省自然科学基金项目(Z2007C02)

摘　　要：目的:探讨EV71引起小儿手足口病与其他肠道病毒所致手足口病的临床特点的差异。方法:回顾性分析2009年3月-9月菏泽地区各定点医院收治的病原学检测为阳性的320例小儿手足口病的临床资料,筛出EV71感染的手足口病患儿进行分析,其他肠道病毒所致手足口病患儿作为对照组。结果:菏泽地区2009年抽取的病原学检测为阳性的320例患儿,肠道病毒71型引起手足口病占106例,其余为其他肠道病毒所致手足口病。(1)男女发病基本相同,发病年龄1～3岁居多,农村患儿占绝大多数。(2)EV71感染的患儿临床主要表现高热、神经系统症状、无皮疹,大多数外周血象高、血糖高,可合并心肌损害,心电图异常、部分发现胸片、脑电图及核磁异常,部分符合重症手足口病标准。(3)其他肠道病毒感染的患儿临床症状以皮疹、低热、上感症状为主,少数患儿有精神差,基本不出现神经系统症状,少数发现外周血象高、血糖高、合并心肌损害,一般胸片不会发现异常。(4)56例出现神经系统症状的患儿收集脑脊液进行两次RT-PCR扩增,发现50例EV71阳性。结论:EV71导致的手足口病,病情凶险,易致神经损害及肺水肿,早期识别重症病例,及时救治,普及病原体的检测对提高诊治能力,加强疾病的认识,对减少致残率及死亡率很有帮助。Objective:To investigate the clinic difference between infant hand-foot and mouth disease caused by enterovirus 71 and other enterovirus. Methods:The 320cases who were suffered from hand-foot and mouth disease of designated hospitals in HeZe were retrospectively analyzed and stool specimens of all children were collected. The cases caused other enterovirus were chosn as control group. Results:106 cases are caused by EV71, the rest were caused by other enterovirus. ⑴The incidence for boys and girls are the same, mainly in 1 to 3-year-old children and patients in rural areas were more than that in urban. ⑵The symptoms of cases caused by EV71 are high fever, neurological symptoms, and no rash; The peripheral blood and blood sugar in majority cases are increased; The myocardial of majority are injured; There were ECG abnormalities, and chest X-ray, EEG and magnetic resonance imaging abnormalities in.some cases. ⑶ The symptoms of cases caused by other enterovirus are Skin rash, fever, upper respiratory symptoms and minority of cases with mental difference. Nervous system symptoms are not appeared. Peripheral blood and blood sugar of cases are increased in some cases. There were some complicated with myocardial damage, but there were not abnormal in chest and X-ray. ⑷There were 50 cases caused by EV71 infection in 56 children who had abnormal nervous system Conclusions:The hand-foot-mouth disease caused by EV71 is a dangerous disease that can easily lead to central nervous damage and pulmonary. Early identification and timely treatment in severe cases is very important. To universe detection of pathogens is helpful in improving diagnosis and treatment capacity and enhance understanding of the disease can reduce morbidity and mortality.

关 键 词：手足口病 EV71 其他肠道病毒 

分 类 号：R725.1[医药卫生—儿科]