手足口病患儿血清中甲型肝炎病毒检测及临床分析  

Detection and clinical analysis of hepatitis A virus in children with Hand,Foot and Mouth Disease

作　　者：杜潘艳[1] 乔国昱 赵丽梅[1] 王晓波[1] 

机构地区：[1]河北省唐山市妇幼保健院检验科,河北唐山063000 [2]唐山市协和医院检验科,河北唐山063000

出　　处：《现代预防医学》2015年第7期1339-1341,共3页Modern Preventive Medicine

摘　　要：目的检测手足口病患儿血清中甲型肝炎病毒(HAV),分析合并HAV感染对患儿的影响。方法收集2009.6月-2013.10月确诊手足口病例577例。用酶联免疫吸附试验检测血清HAV抗-Ig M,比较甲肝合并肠道病毒71型(EV71)和科萨齐病毒A组16型(Cox A16)的感染率;分析比较合并甲肝感染组与非合并组患儿的临床表现;检测患儿血清中肝功能指标ALT、AST、ALP、GGT、PA、TBIL和DBIL水平,分析合并组与非合并组患儿肝功能损伤情况。结果 577例手足口病患儿中合并甲肝病毒感染32例,合并EV71感染率(6.9%)与合并Cox A16(3.2%)比较,差异无统计学意义(P>0.05);合并组患儿中精神差、抽搐、恶心、呕吐等神经系统症状较非合并患儿明显(P<0.05),而发热、乏力、纳差、腹痛、巩膜黄和尿色深在两组间比较,差异无统计学意义(P>0.05);合并组病程较非合并组长(P<0.05);合并组肝功能指标ALT、AST、GGT、ALP、TBIL、DBIL水平分别高于非合并组,而PA水平低于非合并组,各指标在两组间均有统计学意义(P<0.05)。结论手足口病患者中存在甲型肝炎病毒感染,合并甲型肝炎病毒感染对手足口病病情发展有促进作用。Objective To detect HAV-Ig M of the children with Hand, Foot and Mouth Disease（HFMD）, and analyze the influence of co-infection on clinical aspects. Methods Between June 2009 and October 2013, there were 577 HFMD patients enrolled in the study. ELISA were performed to detect HAV-Ig M. HAV and HFMD co-infection patients were found out, then the rates of co-infection with HAV between EV71 and Cox A16 groups were compared; Clinic symptom in co-infection with HAV and non-co-infection children were analyzed and compared; The liver function indexes（ALT, AST, ALP, GGT, PA, TBIL and DBIL）were tested, then the states of liver function in co-infection and non-co-infection groups were analyzed and compared. Results 32 cases were detected as positive for HAV-Ig M in 577 co-infection HFMD children. The rates of co-infection with EV71（6.9%） and Cox A16（3.2%） were compared, and there was no difference（P0.05）; the rates of low-spirit, nausea, twitch, vomit and low-orexis in co-infection HAV children were higher than those of non-co-infection group（P0.05）, but no differences were observed for fever, feeble, low-orexia, abdomen-pain, icteric sclera, urine with deep color（P0.05）; the serum levels of ALT, AST, ALP, GGT,TBIL and DBIL in co-infection group were higher than those in non-co-infection group（P0.05）, respectively, but PA level was lower than that in non-co-infection group. Conclusion HAV infection has a promoting effect on HFMD development.

关 键 词：手足口病 甲型肝炎病毒 儿童 传染病 

分 类 号：R183[医药卫生—流行病学]