肠道病毒71型和柯萨奇病毒A组16型所致手足口病相关特征分析  

A comparison of the characteristics of diseases caused by enterovirus 71 or coxsackievirus A16

作　　者：姚学君 金鹏飞[1] 嵇红[2] 李靖欣[2] 胡月梅[2] 孟繁岳[2] 甘正凯[3] 周洋[3] 张雪峰[2] 朱凤才[1,2] 

机构地区：[1]南京医科大学公共卫生学院流行病与统计学系,江苏南京210029 [2]江苏省疾病预防控制中心疫苗临床评价所,江苏南京210009 [3]东南大学公共卫生学院流行病与统计学系,江苏南京210009

出　　处：《中华疾病控制杂志》2015年第4期385-388,共4页Chinese Journal of Disease Control & Prevention

基　　金：国家青年自然科学基金(81402732);"十二五"国家传染病防治科技重大专项(2012ZX1002-001)

摘　　要：目的探讨肠道病毒71型（enterovirus 71,EV71）和柯萨奇病毒A组16型（coxsackievirus A16,CA16）所致疾病在流行病学和临床特征方面有无差异。方法采用调查问卷方式,收集研究现场＂可疑肠道病毒病＂监测系统发现的病例数据,比较分析EV71和CA16感染患儿的流行特征和临床特征。结果两组患儿疾病均以手足口病为主,其中EV71感染致手足口病更多见,CA16感染致呼吸道感染和非特异性疾病所占病例比例较高（均有P〈0.001）。EV71感染患儿皮疹、呕吐、抽搐、烦躁不安、惊厥和嗜睡症状发生率均高于CA16感染（均有P〈0.05）;EV71感染患儿的发病病程比CA16感染长（Z=-10.22,P〈0.001）;CA16感染致流涕症状比EV71感染更多见（χ^2=6.36,P=0.012）。CA16和EV71感染患儿月龄和性别差异无统计学意义,发病高峰均为4-6月份,其中CA16感染病例明显多于EV71感染。结论 EV71和CA16感染患儿流行病学特征基本相似。EV71感染较CA16感染的临床症状和体征更为复杂,易出现神经系统症状。Objective To analyze the difference of epidemiological and clinical characteristics in children with diseases caused by Enterovirus 71（ EV71） or Coxsackie virus A16（ CA16）. Methods The cases were collected by the active and passive surveillance systems for enterovirus disease. And all cases were investigated by questionnaire to access full record of the epidemiological and clinical information of the disease caused by EV71 or CA16. Results The most common disease caused by EV71 was HFMD,while the respiratory infection and nonspecific disease were frequently seen in CA16 infection（ all P〈 0. 001）. Higher incidence of skin rash,vomiting,convulsion,dysphoria and lethargy caused by EV71 were observed than by CA16（ all P〈0. 05）. Longer disease course was noted in the cases associated with EV71（ Z =- 10. 22,P 〈0. 001）. However,CA16 infection frequently caused rhinorrhea（ χ^2= 6. 36,P = 0. 012）. Epidemiological data showed that there were no significant difference in age and gender between EV71 and CA16 cases,and the peak was observed between April and June. Conclusions The epidemiological and clinical characteristics are similar in children infected by EV71 and CA16,while EV71 could cause more complex clinical symptoms,especially predisposition to suffer from nervous system symptoms.

关 键 词：肠道病毒A型 柯萨奇病毒感染 流行病学方法 

分 类 号：R373.25[医药卫生—病原生物学] R181.22[医药卫生—基础医学]