不同病程手足口病患者咽拭、肛拭配对标本肠道病毒检出率的比较  

Comparison of enterovirus detection rates in paired specimens of throat swabs and anus swabs from patients in different phases of hand-foot-mouth disease

作　　者：李颐[1] 居丽雯[2] 蒋露芳[2] 沈磊[1] 赵文良[1] 沈琦[1] 蔡明毅[1] 孟威[1] 姜庆五[2] 

机构地区：[1]上海市静安区疾病预防控制中心质量科,200041 [2]复旦大学公共卫生学院卫生微生物学教研室公共卫生安全教育部重点实验室

出　　处：《中华传染病杂志》2013年第3期170-172,共3页Chinese Journal of Infectious Diseases

基　　金：上海市重点学科建设资助项目（09D21906605）

摘　　要：目的比较不同病程手足V1病患者咽拭、肛拭配对标本中肠道病毒的检出率。方法采集2010年7月至2011年12月上海市儿童医院临床诊断手足口病患儿175例咽拭、肛拭配对标本，采用实时一PCR法进行柯萨奇病毒A组16型（CoxAl6）、肠道病毒71型（EV71）和其他EV属检测，分析不同病程配对标本肠道病毒检出率。配对标本行McNemar检验。结果175例患者的配对标本CoxA16、EV71、其他EV属咽拭子阳性率分别为38．29％、20．57％和8．00％，肛拭子阳性率分别为44．O。％、23．43％和13．14％。结果显示两种标本检测结果的差异均有统计学意义（均P〈0．01）。发病当天至发病后2d及4～lld肛拭EV71阳性率均比咽拭阳性率高；发病后2～3d肛拭CoxA16阳性率均比咽拭阳性率高；发病当天至发病后3d肛拭其他EV属阳性率均比咽拭阳性率高。对于EV71，咽拭标本在发病后3～11d均可检出阳性，而CoxA16、其他EV属在发病3d后都无法检出阳性。结论肛拭标本总体阳性率高于咽拭标本。EV71在呼吸道带毒持续时间长于CoxA16和其他EV属。在发病2d内肠道病毒在咽部繁殖扩增，此时病毒可通过呼吸道途径传播。[Abstractl Objective To compare the detection rates of enterovirus in paired specimens of throat swabs and anus swabs from patients with different phases of hand-food-mouth disease （HFMD）. Methods A total of 175 paired throat swabs and anus swabs from patients who were clinically diagnosed with HFMD in Children＇s Hospital of Shanghai from July 2010 to December 2011 were collected. Real-time reverse transcription polymerase chain reaction （RT-PCR） to detect Enterovirus 71 （EV71）, Coxsackievirus group A type 16 （CoxA16） and other Enterovirus（EV） was performed. The detection rates of paired specimens within different phases of the disease were compared. Results Among the 175 pairs of specimens, the positive rates of CoxA16, EV71 and other EV in throat swabs were 38.29%, 20. 57% and 8.00%, respectively, and in anus swabs were 44.00%, 23.43% and 13.14%, respectively. McNemar test showed significant difference of the detection rates between throat swabs and anus swabs （for CoxA16, EV71 and other EV, P〈0.01）. The detection rate was higher in anus swabs than that in throat swabs for EV71 on 0 to 2 days and 4 to 11 days afteronset, for CoxA16 on 2 to 3 days after onset, and for other EV on 0 to 3 days after onset. EVT1 could be detected in throat swabs 3 to 11 days after onset, while CoxA16 and other EV couldnrt be detected 3 days after onset. Conclusions The overall positive rates of anus swabs are higher than those of throat swabs for EV. EVT1 stays longer in the respiratory tract than CoxA16 and other EV. EV proliferates in pharynx within 2 days after onset and can be transmitted through the respiratory tract in the meantime.

关 键 词：手足口病 肠道病毒属 肠道病毒A型 人 柯萨奇病毒感染 

分 类 号：R72[医药卫生—儿科]