1073例儿童手足口病病原学检测结果及临床特征分析  

Etiology analysis and the clinical characteristics of 1073 children with hand-food-mouth disease

作　　者：李润青[1] 何菡[1] 赵秀英[1] 孙桂珍[1] 乔桂芳[2] 吴昊[3] 李俊红[4] 金荣华[5] 

机构地区：[1]首都医科大学附属北京佑安医院临检中心,100069 [2]首都医科大学附属北京佑安医院生物医学信息中心,100069 [3]首都医科大学附属北京佑安医院感染科,100069 [4]首都医科大学附属北京佑安医院急诊科,100069 [5]首都医科大学附属北京佑安医院院办,100069

出　　处：《北京医学》2011年第9期709-712,共4页Beijing Medical Journal

基　　金：国家重大科技专项(2009ZX10004-110);佑安肝病-艾滋病基金(BJYAH-2009-007)

摘　　要：目的了解手足口病(HFMD)儿童病例中肠道病毒71型(EV71)和柯萨奇病毒A组16型(CA16)的感染状况及重症HFMD病例的临床特征和实验室检查结果。方法采集HFMD患儿咽拭子标本,检测EV71和CA16感染情况,分析患儿性别、年龄分布情况并对重症患儿的临床特征和实验室检查结果进行回顾性分析。结果 1073例HFMD患儿中EV71阳性494例(46.04%),CA16阳性97例(9.04%),EV71阳性检出率明显高于CA16(P=0.001)。494例EV71阳性患儿中,男299例(60.53%),女195例(39.47%);97例CA16阳性患儿中,男59例(60.82%),女38例(39.18%),男性患儿构成比显著高于女性。EV71或CA16阳性患儿中"1～<2岁"组和"2～<3岁"组构成比明显高于其他年龄组。本组重症病例62例,其中重型50例(80.65%),危重型12例(19.35%)。前者以神经系统表现为主,循环系统、呼吸系统轻度受累,无死亡病例;后者并发神经系统、循环系统、呼吸系统等多器官功能损害,5例死亡。结论 2010年北京地区HFMD流行的病原体的优势株可能为EV71;男性患儿高于女性,1～3岁儿童为易感人群。危重型可引起死亡,实验室指标的变化对协助诊断重型HFMD及提示重型向危重型进展有一定意义。Objective To analyze the infectious status of Enterovirus 71（EV） and Coxsackie virus A16（CA16） in children with hand-foot-mouth disease（HFMD） and analyze the clinical characteristics and laboratory results of severe HFMD cases.Methods Throat swab samples of children with HFMD were collected,and EV71 and CA16 were detected.Demographic data,such as gender and age distribution were analyzed and the clinical characteristics and laboratory results of severe HFMD cases were analyzed retrospectively.Results Among 1073 HFMD cases,494（46.04%） were EV71-positive and 97（9.04%） were CA16-positive,the positive detection rate of EV71 was significantly higher than that of the CA16（P = 0.001）.There were 299（60.53%） boys and 195（39.47%） girls among 494 EV71-positive cases,and 59（60.82%） were boys,38（39.18%） were girls among 97 CA16-positive cases.The percentage of boys was higher than that of girls.Among EV71 or CA16 positive patients,the proportion of children who were between the age of 1 to 2 years old and 2 to 3 years old was higher than that of patients in other groups.Among 1073 HFMD cases,62 had severe HFMD,and they could be further classified into 2 groups based on clinical characteristics and complications.Group I（severe HFMD group）,in which 50 cases（80.65%） were alive.They had predominant nervous system complications but mild circulation system involvement and respiratory syndromes.Group Ⅱ（very severe HFMD group）,in which 12 cases（19.35%） developed multiple organ damages,including nervous system,circulation and respiratory system damages,and 5 patients died finally.Conclusion The predominant virus of HFMD outbreak in Beijing in 2010 is EV71,and the percentage of boys is higher than girls.Children at 1～3 years old are susceptible to HFMD and should be protected.Very severe cases with multiple organ damages account the majority deaths.Changes of laboratory parameters contribute to the diagnosis of severe HFMD and could shed light on the progression from severe HF

关 键 词：手足口病 肠道病毒71型 柯萨奇病毒A组16型 逆转录PCR 

分 类 号：R725.1[医药卫生—儿科]