郑州市二七区2008～2012年住院手足口病患者病原、临床特征及流行因素调查  

Study on pathogenic monitoring and clinical characteristics of hand-foot-mouth disease 2008- 2012 in Erqi district of Zhengzhou city

作　　者：冯慧芬[1,2] 段广才[1] 张卫东[1] 

机构地区：[1]郑州大学公共卫生学院流行病学教研室,郑州450001 [2]郑州大学第五附属医院感染科,郑州450052

出　　处：《郑州大学学报（医学版）》2014年第2期184-188,共5页Journal of Zhengzhou University(Medical Sciences)

基　　金：国家自然科学基金资助项目81172740

摘　　要：目的：了解手足口病（ HFMD）病原、临床特征及其主要流行因素，为科学制定郑州市二七区HFMD的防控措施提供依据。方法：采用RT-PCR方法对河南省郑州市二七区HFMD定点医院2008～2012年住院HFMD患者的粪便标本2932份进行肠道病毒、肠道病毒71型（ EV71）和柯萨奇病毒A16型（ CoxA16）检测，并观察其临床特征，分析其主要流行因素。结果：2932份粪便标本中有2062份检出肠道病毒，其中748份EV71阳性，527份CoxA16阳性，787份其他肠道病毒阳性。2008、2009、2010、2011、2012年该地区住院HFMD患者病原体构成不全相同（χ2＝109．741，P＜0．001），EV71是2010年HFMD流行的主要病原体。肠道病毒的流行集中于3～7月份，4、5月份达到高峰；93．50％的肠道病毒感染发生于0．5～4．0岁儿童，其感染的型别与患儿的年龄、性别、居住地无关。201例重症HFMD患者中，EV71阳性90例，阳性率高于普通患者，主要表现为脑炎和无菌性脑膜炎，其中2例死亡（死于脑炎和肺水肿或肺出血）。结论：2008～2012年河南省郑州市二七区HFMD流行期间有多种肠道病毒流行， CoxA16和EV71是引起HFMD的主要病原体，EV71是导致重症病例和死亡病例的主要病原体。Aim：To find out the state of the enterovirus infection and clinical characteristics of hand -foot-mouth disea-ses（HFMD） in order to make prevention and control strategy .Methods： Enterovirus, enterovirus 71 （EV71） and Cox-sackievirus A16（CoxA16） were diagnosed through RT-PCR in patients hospitalized with HFMD 2008-2012 in Erqi district of Zhengzhou city .Clinical characteristics of the patients with HFMD were also studied .Results： Among 2 932 patients with HFMD, the positive samples for EV71, CoxA16 and other enteroviruses were 748, 527 and 787 respectively.The an-nual epidemics of the pathogens were various from 2008 to 2012 （χ2 =109.741,P〈0.001）.HFMD was mainly during summertime prevalent and peaked in April and May .Most （ 93 .50%） cases occurred in children who were between 6 months and 4 years old.Severe HFMD had a higher rate of EV 71 infection than mild patients .Among 201 patients with se-vere complications , 2 died of pulmonary edema and pulmonary hemorrhage .Conclusion： Several enteroviruses were epi-demic during the 2008-2012 HFMD epidemic period , among which , the CoxA16 and EV71 are the important pathogens of HFMD.EV71 infection is associated with most of the serious clinical manifestations and with all the deaths .

关 键 词：手足口病 肠道病毒 肠道病毒71型 柯萨奇病毒A16型 ENTEROVIRUS 71 Coxsackievirus A16 

分 类 号：R181.3[医药卫生—流行病学]