2013-2017年河北省其他肠道病毒手足口病流行及病原构成特征分析  

Epidemiological characteristics and pathogenic monitoring of hand,foot,and mouth disease due to an enterovirus other than enterovirus 71 or Coxsackievirus A16 in Hebei from 2013-2017

作　　者：张文俊 刘莹莹[2] 于秋丽[2] 苏通[2] 赵文娜[2] 谢赟[2] 齐顺祥[2] 李琦[2] ZHANG Wen-jun;LIU Ying-ying;YU Qiu-li;SU Tong;ZHAO Wen-ha;XIE Yun;QI Shun-xiang;LI Qi(School of Public Health,North China University of Science and Technology,Tangshan,Hebei 063000,China;Institute for Viral Disease Prevention and Control,Hebei Provincial Center for Disease Control and Prevention)

机构地区：[1]华北理工大学公共卫生学院,河北唐山063000 [2]河北省疾病预防控制中心病毒病防治所

出　　处：《中国病原生物学杂志》2018年第10期1126-1130,共5页Journal of Pathogen Biology

基　　金：国家科技重大专项(No.2013ZX10004202);河北省重大医学科研资助项目(No.zd2013068);河北省科技计划项目(No.172777111D)

摘　　要：目的分析2013-2017年河北省其他肠道病毒手足口病的流行特征及病原体构成,为该地区手足口病的防控提供理论依据。方法收集2013-2017年河北省其他肠道病毒手足口病病例个案调查表,采用描述性方法描述疾病的三间分布。采集手足口病患者的肛拭子(或咽拭子)标本,采用RT-PCR或Real time RT-PCR对其他肠道病毒、肠道病毒71型(EV-A71)和柯萨奇病毒A16型(CV-A16)特异核酸进行检测。取其他肠道病毒阳性标本,用RD细胞进行病毒分离培养,对分离毒株进行VP1基因序列扩增及基因序列测定。结果 2013-2017年河北省手足口病实验室累计报告其他肠道病毒手足口病病例8 793例,人群年均发病率为23.72/100万。不同年份之间其他肠道病毒手足口病发病率差异有统计学意义(χ~2=743.7,P<0.05)。其中重症病例92例,年均重症病例占比为1.05%。患者男女性别比为1.58∶1,以1~岁年龄组发病人数较多,占59.31%。每年3月份病例开始增多,5~7月达到高峰,之后逐渐减少。2013-2017年全省11个地市均有病例报告,且呈散发、局部高发的特点。其中,年均病例数居前3位的分别为石家庄、保定和唐山市,占年均病例总数的51.90%。共鉴定其他肠道病毒15种,其中CV-A6、CV-A10分别占57.60%和22.58%。结论河北省其他肠道病毒手足口病的发生有明显的季节性、人群和地区差异,CV-A6、CV-A10为主要病原体,但应重视手足口病病原谱的变化,为疾病预防策略的制定提供参考。Objective To analyze the epidemiological characteristics of and pathogens other than enterovirus 71 or Coxsackievirus A16 causing hand, foot, and mouth disease （HFMD） in Hebei from 2013-2017 in order to provide a the- oretical basis for HFMD prevention and control. Methods Descriptive epidemiology was used to depict the distribution of HFMD due to an enterovirus other than enterovirus 71 or Coxsackievirus A16 in Hebei from 2013 to 2017. Clinical specimens were collected from patients with HFMD to detect human enterovirus 71, Coxsackievirus A16, and other enteroviruses using RT-PCR or real time RT-PCR. If specimens were positive for other enteroviruses, those enteroviruses were isolated and cultured with RD cells. The VP1 regions of the isolates were amplified and sequenced. Results In total, 8 793 cases of HFMD due to an enterovirus other than enterovirus 71 or Coxsackievirus A16 were reported in Hebei during this period, with an average incidence of 23.72/1 000 000. A chi-square test indicated that the incidence of HFMD due to an enterovirus other than enterovirus 71 or Coxsackievirus A16 differed significantly by year （χ^2= 743.7, P〈0. 05）. Of the cases of HFMD, 92 were severe; severe cases accounted for 1.05% of the cases of HFMD annually. The male to female ratio of patients was 1.58： 1. Children ages 1-3 accounted for up to 59.31% of patients with HFMD due to an enterovirus other than enterovirus 71 or Coxsackievirus A16. The number of cases began to increase in March, peak between May and July, and then gradually decline. From 2013-2017, cases were reported in 11; cases were scattered with local clusters. The 3 cities with the largest number of cases annually were Shijiazhuang, Baoding, and Tangshan, ac- counting for an average of 51.90% of all cases each year. Fifteen other enterovirus species besides enterovirus 71 and Coxsackievirus A16 were identified, including CV-A6 （57.60%） and CV-A10 （22.58%）. Conclusion The incidence of HFMD due to an enterovirus other than enterovirus 71 or Co

关 键 词：手足口病 其他肠道病毒 流行特征 病原构成 

分 类 号：R512.5[医药卫生—内科学]