2013～2014年湖州市手足口病病原和临床特征分析  

Analysis of pathogens and clinical characterization of hand, foot and mouth disease in Huzhou city from 2013 to 2014

作　　者：黄秋玲[1] 吴烨[1] 王家蔚[1] 徐震[1] 姜志强[2] 高敏[1] 崔大伟[3] 陈瑜[3] 王翔[2] 

机构地区：[1]浙江省湖州市中心医院儿科,浙江湖州313003 [2]浙江省湖州市第一人民医院儿科,浙江湖州313000 [3]浙江大学医学院附属第一医院检验科,浙江杭州310003

出　　处：《中国现代医生》2015年第13期44-46,49,共4页China Modern Doctor

基　　金："十二五"国家科技重大专项(2012ZX10004-210)

摘　　要：目的：了解湖州市2013--2014年手足口病病原构成及其临床相关特征。方法采集208例疑似手足口病感染者的253份标本（咽拭子45份和粪便208份）和相关临床资料，采用一步法三色荧光定量RT-PCR检测临床样本。结果一步法荧光定量RT-PCR检测表明，208例手足口病患儿中，EV的检出率为83.17%（173/208），其中EV71、CoxA16和其他EV亚型所占EV的比例分别为55.49%、13.29%和31.21%，且男、女患儿之间的检测结果并无显著差异。5岁及以下（≤5岁）手足口病患儿中，主要的病原为EV71，而5岁以上以其他EV亚型为主；临床症状以发热伴疱疹为手足口病的主要症状，而引起发热伴呕吐、疱疹或神经系统症状的主要肠道病毒为EV71。此外粪便样本的EV检出率高于咽拭子样本的EV检出率。结论肠道病毒EV71和其他EV亚型是湖州市儿童手足口病的优势病原体，而CoxA16病毒呈现下降趋势，因此加强EV、EV71和CoxA16的监测有助于更好地预防和控制手足口病。Objective To explore the pathogens and clinical characterization of hand,foot and mouth disease （HFMD）in Huzhou city from 2013 to 2014. Methods All 253 specimens included 208 stool specimens and 45 throat swabs,and clinical data from 208 children cases with hand,foot and mouth diseases （HFMD）were collected. Preliminary de-tection for all of the specimens was performed by one-step triple real-time RT-PCR assay. Results Real-time RT-PCR assay indicated that the positive rate of Enterovirus（EV）from 208 cases was 83.17%（173/208）,and the percent-ages of EV71,CoxA16 and other＆#39;s EV subtypes in 173 enteroviruses were 55.49%,13.29%and 31.21%,respectively. These results were not significant differences between male and female children. EV71 from children with HFMD was predominant strain below 5 old years （≤5）,and other＆#39;s EV subtypes were predominant strains over 5 years （〉5）. Of fever with herpes was main clinical symptom in patients with HFMD,and EV71 was primary enterovirus induced many clinical features, such as fever with herpes or vomiting or neurological symptoms and so on. Additionally, detection rate of EV in stool specimens was significant higher than that in throat swabs. Conclusion EV71 and other＆#39;s EV sub-types are predominant strains, CoxA16 strains have a downtrend in patients with HFMD in Huzhou city, so that the medical workers should improve the ability of surveillance to EV,EV71 and CoxA16 in order to make better for control and prevention of the HFMD diseases.

关 键 词：手足口病 肠道病毒71型 柯萨奇病毒A16型 

分 类 号：R512.5[医药卫生—内科学]