手足口病患儿不同类型肠道病毒感染临床特点分析  

The clinical characteristics of different enterovirus infections in pediatric patients with HFMD

作　　者：赵倩[1] 张景丽[2] 蒋秀芳[1] 程思思[1] 万丽[3] 王立娜[1] ZHAO Qian;ZHANG Jing-li;JIANG Xiu-fang;CHENG Si-si;WAN Li;WANG Li-na(The First Hospital affiliated with Hebei Medical University,Shijiazhuang 050031,China;Children＇s Hospital of Hebei Province;Shijiazhuang Center for Disease Control and Prevention)

机构地区：[1]河北医科大学第一医院,河北石家庄050031 [2]河北省儿童医院 [3]河北省石家庄市疾病预防控制中心

出　　处：《中国病原生物学杂志》2018年第7期755-758,共4页Journal of Pathogen Biology

基　　金：河北省卫生厅青年科技课题(No.20160707)

摘　　要：目的探讨不同类型肠道病毒感染手足口病患儿的临床特点,指导临床疾病预防和治疗。方法收集456例手足口病患儿临床资料,采用实时荧光定量PCR检测EV71和CoxA16病毒感染情况。观察患儿临床特征,口腔疱疹分布情况,以及手部、足部皮疹分布情况,并进行统计学分析。结果 EV71感染患者数262例,CoxA16感染患者数194例。CoxA16型病毒性手足口病患儿发生咳嗽、嗜睡、惊厥、肌肉痉挛的比例显著高于EV71型,而EV71型病毒性手足口病患儿发生呕吐的比例显著高于CoxA16型,差异有统计学意义(P均<0.05)。CoxA16型病毒性手足口病患儿在上腭、咽峡部、颊粘膜发生口腔疱疹的比例显著高于EV71型,差异有统计学意义(P均<0.05)。但两组手足口病患者间手部和足部皮疹分布情况并差异不显著。结论 EV71和CoxA16型病毒性手足口病仍然是最常见类型,CoxA16型患者易发生咳嗽、嗜睡、惊厥、肌肉痉挛,EV71型患者易发生呕吐。CoxA16型患者口腔疱疹易发生在上腭、咽峡部、颊粘膜。积极监测肠道病毒类型对控制患儿病情有重要意义。Objective The clinical characteristics of different enterovirus infections in pediatric patients with hand,foot,and mouth disease（HFMD）were investigated to guide the clinical prevention and treatment of HFMD. MethodsClinical data on 456 pediatric patients with HFMD were collected,and the prevalence of EV71 and CoxA16 was determined using fluorescence quantitative PCR.The clinical features of HFMD and the prevalence of mouth sores and rashes on the hands and feet were examined,and data were statistically analyzed. Results Two hundred and sixty-two pediatric patients were infected with EV71,and 194 were infected with CoxA16.Pediatric patients infected with CoxA16 had a significantly higher incidence of coughing,sleepiness,seizures,and muscle spasms than did pediatric patients infected with EV71,but patients infected with EV71 had a higher incidence of emesis than did pediatric patients infected with CoxA16.The frequency of symptoms differed significantly between the groups（P〈0.05）.Pediatric patients infected with CoxA16 had a significantly higher incidence of mouth sores than did pediatric patients infected with EV71.The frequency of mouth sores differed significantly between the groups（P〈0.05）.However,skin rashes on the hands and feet did not differ significantly between the two groups of pediatric patients. Conclusion Pediatric patients with HFMD were most often infected with EV71 or CoxA16.Patients infected with CoxA16 had a higher incidence of coughing,sleepiness,seizures,and muscle spasms,but patients infected with EV71 had a higher incidence of emesis.Patients infected with CoxA16 had a higher incidence of mouth sores on the palate,the isthmus of the fauces,and the buccal mucosa.The type of enterovirus causing HFMD should be actively monitored to control the incidence of HFMD in children.

关 键 词：手足口病 患儿 肠道病毒感染 临床特点 

分 类 号：R373.2[医药卫生—病原生物学]