柯萨奇病毒A6手足口病在不同年龄组的临床特征分析  

Clinical characteristics of hand,foot and mouth disease caused by coxsackievirus A6 in different age groups

作　　者：张楠[1] 黄辉[1] 贾立平[2] 于方圆 金凤华[1] 郑崇光[1] 周丽君 吴婷婷 张榕 邓莉[1] Zhang Nan;Huang Hui;Jia Liping;Yu Fangyuan;Jin Fenghua;Zheng Chongguang;Zhou Lijun;Wu Tingting;Zhang Rong;Deng Li(Department of Infections Diseases,Capital Institute of Pediatrics Affiliated Children Hospital,Beijing 100020,China;Laboralory of Virology,Beijing Key Laboratory of Etiology of Viral Diseases in Children,Capital Institute of Pediatrics,Beijing 100020,China)

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儿童病毒病病原学北京市重点实验室,北京100020

出　　处：《中华实验和临床病毒学杂志》2019年第5期495-499,共5页Chinese Journal of Experimental and Clinical Virology

摘　　要：目的回顾性分析柯萨奇病毒A组6型(coxsackievirus A6,CV-A6)感染在不同年龄组手足口病(hand,foot and mouth disease,HFMD)的临床特点。方法对2015年1月—2017年12月疑似或临床诊断为HFMD的患儿留取咽拭子标本,采用实时荧光定量聚合酶链反应(Real-Time PCR)方法检测标本中肠道病毒核酸,将CV-A6阳性病例按年龄进行分组比较。结果467例CV-A6阳性HFMD病例,年龄3月~16岁,婴幼儿组(≤3岁)273例,学龄前期组(3~6岁)131例,学龄期组(>6岁)63例,5~11月份为发病高峰;发热为常见症状,其中婴幼儿组发热发生率最高(220/273,80.5%);婴幼儿组白细胞升高比例最高(127/273,46.5%),高于学龄期组(17/63,27.0%),组间比较存在统计学意义;CV-A6所致HFMD皮疹形态多样,婴幼儿组皮疹多形性比例最高(163/273,59.7%);学龄期组分布部位数最少(0.89±0.86);婴幼儿组肘关节(109/273,39.9%)、膝部(88/273,32.6%)、大腿(112/273,41%)、臀部(122/273,44.7%)皮疹发生率高于其他两组,学龄期组前臂(0/63,0%)、足心(41/63,65.1%)、小腿(0/63,0%)、大腿(6/63,9.5%)皮疹发生率低于其他两组,组间比较差异均存在统计学意义;全部病例均临床痊愈,无重症病例发生,发病6个月后共有288例接受随访,其中33例发生甲脱落(33/288,11.5%)。结论不同年龄组CV-A6所致HFMD临床表现存在差异,婴幼儿组更常出现发热症状,皮疹分布范围更广,皮疹形态更具多形性,血常规白细胞升高更为多见。Objective To analyze the clinical characteristics of hand,foot and mouth disease(HFMD)caused by coxsackievirus A6(CV-A6)in different age groups.Methods From January 2015 to December 2017,throat swabs were collected from children with or suspected of having HFMD then quantitative real-time PCR was performed to detect enterovirus nucleic acid.HFMD cases caused by CV-A6 were divided into different groups according to age for comparison.Results In total,there were 467 cases of HFMD caused by CV-A6 with the age ranging from 3 months to 16 years.There were 273 cases in the infants and young children group(<3 years old),131 cases in the pre-school group(3-6 years old),and 63 cases in the school-age group(>6 years old).The peak incidence was found between May and November.Fever was the common symptom,and the rate of fever in infant group was the highest(220/273,80.5%);The proportion of cases with leucocyte elevation in the infant group was the highest(127/273,46.5%)than that in the school-age group(17/63,27.0%)with a statistical significance.The skin erythra of the HFMD caused by CV-A6 were diverse in forms.Over two forms of skin erythra accounted for 53.9%(257/476)of all cases,and the cases in the infant group showing more forms of skin erythra(163/273,59.7%).The oral herpes were mainly distributed in the upper palate and pharyngeal isthmus,but the school age group had the least number of distribution sites(0.89±0.86).The cases in the infant group showed higher incidence of skin rash at the elbow joint(109/273,39.9%),knee(88/273,32.6%),thigh(112/273,41%),buttock(122/273,44.7%)than the other two groups,However,the school age group showed lower incidence of skin rash in the lower leg(0/63,0%)and thigh(6/63,9.5%)than the other two groups.The differences between groups were statistically significant.All cases were cured clinically,no severe cases occurred.Among the 288 cases followed up for 6 months,33(33/288,11.5%)suffered from nail exfoliation.Conclusions Different age groups of HFMD caused by CV-A6 had different clinica

关 键 词：柯萨奇病毒A6 手足口病 年龄 临床表现 

分 类 号：R72[医药卫生—儿科]