EV71与CA16所致手足口病的病原学特征分析  

Etiological characteristics of hand,foot,and mouth disease caused by enterovirus type 71 or coxsackievirus A16

作　　者：韩志娟[1] 徐俊昌[2] 孙荣兴[1] 

机构地区：[1]襄阳市中心医院传染病分院,湖北襄阳441003 [2]湖北医药学院附属襄阳医院,湖北襄阳441000

出　　处：《中国病原生物学杂志》2016年第3期268-271,共4页Journal of Pathogen Biology

摘　　要：目的了解肠道病毒71型（EV71）与柯萨奇病毒A组16型（CA16）所致手足口病的病原学分布特点,为临床合理用药提供参考依据。方法选取自2014年3月至2015年2月医院收治的共409例手足口病患儿作为研究对象,采集咽、肛拭子和粪便,进行EV71、CA16和其他肠道病毒的核酸检测与体外分离培养,同时收集该次病程观察期内其他相关临床资料,观察并分析结果。结果409例患儿中检出肠道病毒阳性248例,其中EV71病毒102例（24.94%）,CA16病毒88例（21.52%）,其他肠道病毒58例（14.18%）。在EV71和CA16致病病例中,以12～23月龄婴儿为主分别为53（51.96%）和42（47.73%）。不同月龄组发病数差异有统计学意义（χ2=6.177,P=0.046）;发病时间主要集中在5～7月;重症病例10例（男性6例,女性4例）,占病例总数的4.03%,皆由EV71（7例）和CA16（3例）引起;3个年龄段（6～、12～、24～36月龄）重症病例分别为2、7和1例。EV71、CA16与其他肠道病毒致病病例的病程M值分别为9d、9d和6d,组间差异有统计学意义（χ2=18.199,P〈0.01）,排毒周期的M值分别为11d,9d和6d,组间差异均有统计学意义（χ2=22.463,P〈0.01）。结论肠道病毒手足口病主要为EV71和CA16感染所致,主要感染1～2岁婴幼儿,且具有一定的季节性,病程与排毒周期较长。Objective To investigate the etiological characteristics of hand,foot,and mouth disease（HFMD）caused by enterovirus type 71（EV71）or coxsackievirus A16（CoxA16）and thus guide its clinical treatment. Methods Subjects were 409 patients with HFMD who were diagnosed at this Hospital from March 2014 to February 2015.PCR was used to test for viral pathogens,and relevant clinical data were collected. Results Of the 409 patients with HFMD,248 had HFMD caused by enterovirus,including 102 cases caused by EV71（24.94%）,88 cases caused by CoxA16（21.52%）,and 58 cases caused by some other viral pathogen（14.18%）.In the cases of HFMD caused by EV71 or CoxA16,most patients were children between 12 and 23months of age（51.96% were 12 months of age and 47.73% were 23 months of age）.The difference in incidence in different age groups was statistically significant（χ2=6.177,P=0.046）.The incidence of HFMD peaked from May to July.Ten patients displayed severe symptoms or signs,accounting for 4.03% of all patients.Severe cases of HFMD（6boys and 4girls）were caused by EV71（7cases）or CoxA16（3cases）.Two patients with severe HFMD were 6-11 months of age,7were 12-23 months of age,and 1was 24-36 months of age.HFMD caused by EV71 had a median course of 9days,HFMD caused by CoxA16 had a median course of 9days,and HFMD caused by some other virus had a median course of 6days.The duration of the median course of HFMD differed significantly（χ2=18.199,P〈0.001）.The median time to clearance for HFMD caused by EV71 was 11days,the median time to clearance for HFMD caused by CoxA16,was 9days,and the median time to clearance for HFMD caused by some other virus was 6days.The median time to clearance differed significantly（χ2=22.463,P〈0.001）. Conclusion The enteroviruses that caused HFMD were primarily EV71 and CoxA16.HFMD primarily affected younger children and it did have a certain degree of seasonality.HFMD had a long course and a long time to clearance.This was especially true for HFMD caused by EV71 o

关 键 词：手足口病 肠道病毒EV71 柯萨奇病毒 病原学特征 

分 类 号：R512.5[医药卫生—内科学]