2010-2012年广东省发热伴出疹症候群的病原学研究  

Etiology study on rash and fever illness in Guangdong Province,2010-2012

作　　者：琚雄飞[1] 许岸高 方巧云[1] 黄娟媚 

机构地区：[1]惠州市疾病预防控制中心,广东惠州516003 [2]惠州市整合医学重点实验室,广东惠州516001 [3]惠州市结核病防治研究所,广东惠州516007

出　　处：《中华疾病控制杂志》2013年第8期670-673,共4页Chinese Journal of Disease Control & Prevention

基　　金："十二五"国家科技重大专项(2012ZX10004213)

摘　　要：目的分析2010年8月至2012年8月期间广东省发热伴出疹性疾病(rash and fever illness,RFIs)的病原谱构成及流行特征,为临床诊断、治疗和RFIs的预防控制提供科学依据。方法应用实时荧光定量聚合酶链反应(real-time quantitative polymerase chain reaction,real-time PCR)方法和酶联免疫吸附测定(enzyme-linked immu-nosorbent assay,ELISA)方法对519例临床标本进行风疹、麻疹、肠道病毒、水痘-带状疱疹、人类小DNA病毒B19、伤寒副伤寒等病原学检测,并进行统计分析。结果 519例样本中检出314例RFIs病原体阳性标本,阳性率为60.50%。病原谱构成前3位为肠道病毒、水痘病毒和风疹病毒。不同年龄组感染的病原谱构成也不同:0～和5～岁年龄组以肠道病毒71型(human enterovirus 71,EV71)为主,风疹在15～岁年龄组的检出率高于其他年龄组,而水痘在60岁以上年龄组的检出率高于其他年龄组;不同性别患者之间病原体检出率差异无统计学意义。不同病原体在不同年龄组阳性率差异均有统计学意义(均有P<0.05)。结论肠道病毒是本地RFIs感染的主要病原体。部分病原体的感染与年龄有一定的关联,应长期监测RFIs病原体的活动水平。加速肠道病毒疫苗的研制,积极推行水痘、麻疹等疫苗的接种是控制RFIs发病的主要措施。Objective To investigate the pathogens and epidemiological characteristic of rash and fever illness （RFIs） during August 2010 and August 2012 in Guangdong Province so as to provide scientific basis for clinical diagnosis, treatment, prevention and control. Methods Some viruses including Rubella virus, measles virus, enterovirus, Varicella zoster virus （ VZV）, human DNA virus B19, and typhoid and paratyphoid were detected by real-time fluorescent quantita- tive polymerase chain reaction （real-time PCR） and enzyme-linked immunosorbent assay （ELISA）. Statistical analysis was also used in 519 samples. Results Pathogens were found in 314 samples in total, accounting for 60. 50%. The dominated viruses in the pathogen spectrum were enterovirus, Varicella zoster virus （VZV） and Rubella virus. The dominated patho- gens were different with age. Children in age of 0 - and 5 - groups were dominartly affected by EVT1, and the incidence of rubella in age of 15 - 24 was higher than other age groups, and the detection ratio of VZV at the age of 60 years old groups was higher than that of other age groups. The detection rate was not statistically significant among patients of differ- ent gender. The positive rates of pathogens were statistically significant between different age groups. Conclusions En- terovirus was the main pathogen leading to rash and fever illness in Guangdong. Some pathogens＇ incidence rates were re- lated to patients＇age. Particular attention should be paid to the monitoring of rash and fever illness.

关 键 词：发热 聚合酶链反应 流行病学 

分 类 号：R441.3[医药卫生—诊断学]