柯萨奇病毒A6型所致手足口病临床特征分析  

Clinical data analysis on cases of Hand, Foot and Mouth Disease caused by CA6

作　　者：黄辉[1] 邓莉[1] 郑崇光[1] 宋秦伟[2] 邓洁[2] 朱汝南[2] 孙宇[2] 钱渊[2] 

机构地区：[1]首都儿科研究所附属儿童医院感染科,北京100020 [2]首都儿科研究所病毒研究室

出　　处：《中华实验和临床病毒学杂志》2015年第5期443-446,共4页Chinese Journal of Experimental and Clinical Virology

摘　　要：目的 对柯萨奇病毒A6型（CA6）所致手足口病患儿临床表现进行回顾性分析,总结其临床特点,提高临床诊断水平.方法 制定统一手足口病观察表格,采集2013年4月至2014年12月疑似或临床诊断手足口病患儿的临床资料,留取咽拭子标本,采用实时荧光定量PCR法进行肠道病毒核酸检测,分析CA6阳性手足口病患儿临床特征,并与肠道病毒71型（EV71）和柯萨奇病毒A16型（CA16）阳性手足口病患儿进行比较.结果 经病原学确诊并且临床资料完整的809例手足口患者中CA6阳性198例,EV71阳性244例,CA16阳性367例;CA6组发病年龄均数为2.9±2.1岁,较其余两组发病年龄偏小,发热病例多见,齿龈部疱疹相对少见,躯干皮疹多见,且更具多形性,与其他两组之间差异均存在统计学意义（PEV71/CA6、PCA16/CA6均＜0.01）;实验室检查提示CA6组CRP升高病例数较多,与其他两组之间差异存在统计学意义（PEV71/CA6、PCA16/CA6均＜0.01）;随访病例中CA6组有甲脱落（18.3％,26/142）发生;观察全部CA6组病例未见重症手足口病.结论 近年CA6已成为北京地区儿童手足口病新的流行病原之一,其主要临床表现与以往EV71和CA16所致的手足口病有一定的差异,可供临床诊断时参考.Objective To analysis the clinical data from cases of hand,foot and mouth disease （HFMD） caused by CA6,in order to summary the clinical characteristics,and improve the level of the clinical diagnosis.Methods Make an observation table,then record the clinical characteristics and collect throat swabs from children with HFMD,the Real Time RT-PCR was performed to detect viral nucleic acid,analysis the characteristic of the cases of HFMD caused by CA6,and compare with those caused by EV71 and CA16.Results Among 809 cases with complete clinical data and identified pathogen,198 were infected by CA6,244 by EV71,and 367 by CA16.The mean age of onset in-group of CA6 was 2.9 ± 2.1,younger than other two groups.More cases with fever were shown in-group CA6,and more herpes in trunks.All the statistical significance was prominent （PEV71/CA6 〈 0.01、PCA16/CA6 〈 0.01）.The lab test showed more cases with high CRP in group CA6,and there was statistical significance compared with other two groups（PEV71/CA6 〈0.01 、PCA16/CA6 〈 0.01）.During follow-up,nail fall-off were found in some cases ingroup CA6.Among all the 809 cases,there was no severe hand,foot and mouth disease in-group of CA6.Conclusions CA6 was the new and predominant pathogen found in children with HFMD in Beijing district in recent years;Children infected by CA6 showed some different clinical manifestation with those caused by EV71 and CA16.

关 键 词：手足口病 柯萨奇病毒感染 临床特征 

分 类 号：R725.1[医药卫生—儿科]