手足口病22例病原学及临床分析  

Etiology and Clinical Analysis of 22 Children with Hand-Foot-Mouth Disease

作　　者：董国庆[1] 蒋红英[1] 闵慧[1] 赵宏霞[1] 边志卫[1] 田佳[1] 

机构地区：[1]南方医科大学附属深圳妇幼保健院儿科,广东深圳518028

出　　处：《实用儿科临床杂志》2010年第22期1723-1725,共3页Journal of Applied Clinical Pediatrics

摘　　要：目的探讨手足口病（HFMD）的病原学及临床特征。方法研究对象为2008年5-7月在深圳市妇幼保健院儿科住院的HFMD患儿22例,均检测粪便肠道病毒71型（EV71）和柯萨奇病毒A组16型（CoxA 16）核酸,并对患儿的临床表现（包括发热、皮疹和重症早期表现）、实验室检查及治疗转归等资料进行回顾性分析。结果 1.粪便病原检测：EV71 RNA（＋）12例（54.54%）,CoxA 16 RNA（＋）7例（31.82%）,2种病毒均阴性3例（13.64%）。2.病例均有发热和手、足、口腔斑丘疹和（或）疱疹,发热、手足皮疹、口腔疱疹及臀部皮疹持续时间分别为（3.68±1.72）d、（6.02±1.21）d、（5.39±1.22）d和（4.73±0.70）d。3.重症病例早期表现：血白细胞明显增高9例（40.91%）,高热持续不退和高血压各7例（占31.82%）,肺炎6例（27.27%）,高血糖3例（13.64%）,易惊2例（9.09%）,肢体抖动、嗜睡各1例（各4.55%）。4.辅助检查结果：CRP升高8例（36.36%）、低血钠6例（27.27%）、低血糖4例（18.18%）、轻-中度代谢性酸中毒8例（36.36%）及心肌酶谱升高3例（13.64%）、心电图ST段下移和（或）T波低平6例（27.27%）。5.患儿住院时间为（5.00±1.35）d,重症病例早期表现和异常的辅助检查结果分别于治疗1~3 d恢复正常,随访均未见后遗症。结论对HFMD患儿宜采取隔离诊疗观察,根据病情采取分期治疗;对有重症早期表现者,早期发现、早期诊断、早期治疗是控制病情进展的关键。Objective To explore the etiology and clinical characteristics of children with hand-food-mouth disease（HFMD）.Me-thods Twenty-two children with HFMD hospitalized in Shenzhen Maternity and Child Health Care Hospital from May.to Jul.2008 were enrolled.Enterovirus（EV71） RNA and coxsackievirus A16（CoxA 16） RNA were detected in stool samples of the patients,and the clinical features（including fever,skin eruption and severe symptoms in early stage）,laboratory tests and therapeutic outcomes of these patients were retrospectively analyzed.Results 1.EV71 RNA and CoxA 16 RNA were respectively found in 12 cases（54.54%） and 7 cases（31.82%）,but both EV71 RNA and CoxA16 RNA were negative in the rest 3 cases（13.64%）.2.All the patients had fever,maculopapule and/or herpes on hands,feet and mouth,the duration of fever,skin eruption on hands and feet,herpes on mouth and skin eruption on buttock were（3.68±1.72） d,（6.02±1.21） d,（5.39±1.22） d and（4.73±0.70） d,respectively.3.There were significant increase of blood leukocytes in 9 cases（40.91%）,sustainable high fever in 7 cases（31.82%）,hypertension in 7 cases（31.82%）,pneumonia in 6 cases（27.27%）,hyperglycemia in 3 cases（13.64%）,ease of fright in 2 cases（9.09%）,limb shaking and somnolence in 1 case（4.55%）.4.Otherwise,there were high C-reactive protein in 8 cases（36.36%）,low serum sodium in 6 cases（27.27%）,hypoglycemia in 4 cases（18.18%）,mild to mode-rate metabolic acidosis in 8 cases（36.36%）,high myocardial enzymes in 3 cases（13.64%）,and ST segment depression and/or T wave flat in electrocardiogram in 6 cases（27.27%）.5.The average time of hospitalization of the patients was（5.00±1.35） d,severe symptoms in early stage and auxiliary examination abnormality disappeared in 1-3 days after treatment,and sequela was not found in follow-up.Conclusions Patients with HFMD should be diagnosed and treated in isolating room.Stage treatment based on di-sease severity is effective.The key to contr

关 键 词：手足口病 肠道病毒71型 柯萨奇病毒A组16型 临床特征 病原学 

分 类 号：R725.1[医药卫生—儿科]