淮安地区1066例儿童手足口病肠道病毒71型感染流行病学和临床特征分析  

Analysis of epidemiological and clinical features of enterovirus 71 type infection among 1 066 children with HFMD infection in Huaian area

作　　者：吴宏图[1] 丁娴[1] 单春明[1] 周扬扬[2] 

机构地区：[1]江苏省淮安市第二人民医院儿科,江苏淮安223002 [2]江苏省淮安市第二人民医院中心实验室,江苏淮安223002

出　　处：《海南医学院学报》2013年第3期377-380,共4页Journal of Hainan Medical University

基　　金：中国高校医学期刊临床专项资金项目(112210563)~~

摘　　要：目的:了解儿童肠道病毒71型(EV71)在淮安地区小儿手足口病中的感染情况,分析其流行病学特征,探讨EV71感染者的临床特征。方法:选取2008年1月～2010年12月我院儿科收治的1 066例手足口病感染住院患儿,总结其临床特征,用逆转录-聚合酶链反应法(RT-PCR)检测粪便或咽拭子标本中的EV71VP1基因,随机挑选部分阳性PCR扩增产物进行核苷酸测定,并将所测序列在Gen-Bank中进行比较分析。结果:1 066例标本中检测到98例RT-PCR阳性扩增产物,检出率为9.2%,其中2008、2009、2010年度EV71检出率分别为8.4%、7.6%、12.6%。EV71在3年每个月份都有检出,但在2008年5月、2009年6月、2010年7月呈现高峰,分别为24.7%、21.5%、31.8%。98例EV71感染患儿的平均年龄为22个月,临床诊断为疱疹性咽峡炎占3.1%,手足口病合并心肌损害占2.0%,手足口病合并支气管肺炎占20.3%,手足口病占62.2%,手足口病合并脑炎占12.4%。6份EV71VP1基因部分核苷酸片段与GenBank中EV71C4基因序列同源性为93%～99%。结论:淮安地区部分儿童手足口病感染与EV71有关。全年均存在EV71感染,流行季节在春末夏初。EV71感染的临床特征无特异性。Objective： To investigate the status of enterovirus 71（EV71） infection among children with HFMD infections in Huaian area, and to analyze epidemiological and clinical features of EVT1 in children. Methods： One thousands and sixty-six patients admitted between 2008 and 2010 were recruited in the study. The clinical features were analyzed and the specimens collected from stool and throat swabs were inspected for the presence of EV71 by reverse-transcription polymerse chain reaction（RT-PCR）. PCR products of EVT1 VP1 gene from some patients were randomly selected for sequencing analysis, and the sequences of the nucleotides and deduced amino acids were compared with those in the GenBank. Results： Among 1 066 patients, 98（9.2%） showed evidence of EV71 infection. The positive rate of EV71 in 2008, 2009 and 2010 was 8.4% , 7.6% and 12.6%, respectively. The peak times of positive rate of EV71 were May, 2008（31. 8%）, June, 2009（21. 6%//oo）, July month. The median age of patients was 22 months , 2010 （24. 7%）, though it could be detected every EVT1 was identified in patients with stool or throat swabs or both. The infected ehildren were diagnosed as herpangina（3.1%）, HFMD eomplieated with car- dioinjury（2.0%）, HFMD complicated with brochipneumonia （20. 3%）, HFMD（62. 2%）, and HFMD complicated with encephalitis（12. 4%）. Sequence analysis showed that 93%-99% of the EV71 C genes were homologous with the sequence registered in GenBank. Conclusions. This study showed that EV71 ac counts for a small but significant proportion of HFMD infection in infants and children. And EV71 infec tion occurrs all the year round, but prevails predominantedly in the spring and summer. And EV71 infection could not be discriminated from the infection of other HFMD viruses by clinical manifestations.

关 键 词：手足口病感染 肠道病毒71型 儿童 

分 类 号：R373.2[医药卫生—病原生物学] R512.5[医药卫生—基础医学]