昆明市妇幼保健院肠道病毒EV71疫苗接种后手足口病病原构成变化  

The variation of pathogen composition of hand-foot-and-mouth disease after EV71 vaccination in Kunming maternal and child health hospital

作　　者：李秀芳[1] 王艳 张倩[3] 代大春 杨桂云[1] LI Xiu-fang;WANG Yan;ZHANG Qian;DAI Da-chun;YANG Gui-yun(Department of Emergency,The Maternal and Child Health Hospital of Kunming,Kunming Yunnan 650031,China;Department of Outpatient,Pearl Care Clinical of Jinguang Road in Kunming,Kunming Yunnan 650000,China;Department of Clinical Laboratory,The Maternal and Child Health Hospital of Kunming,Kunming Yunnan 650031,China)

机构地区：[1]昆明市妇幼保健院急诊科,云南昆明650031 [2]昆明知贝医疗金广路门诊部,云南昆明650000 [3]昆明市妇幼保健院检验科,云南昆明650031

出　　处：《云南医药》2021年第5期421-423,426,共4页Medicine and Pharmacy of Yunnan

基　　金：昆明市卫生和计划生育委员会医药卫生科技计划项目,编号2018-06-01-016。

摘　　要：目的通过观察疫苗接种前后我院手足口病病原构成变化,了解肠道病毒EV71疫苗接种后免疫保护情况,为肠道病毒EV71疫苗接种推广提供临床客观依据。方法以疫苗投入使用的2016年为分界点,选择昆明市妇幼保健院2014、2015年确诊为手足口病且已行病原学检查的患儿为对照组,2017、2018年确诊手足口病且行病原学检查患儿为观察组。比较2组肠道病毒EV71的感染率;同时把是否EV71感染作为因变量,是否接种疫苗,性别和年龄作为自变量进行多因素分析。结果男童观察组和对照组肠道病毒EV71感染率分别为2.1%、18%,2组之间存在统计学差异(χ2=21.269,P<0.05);女童观察组和对照组肠道病毒EV71感染率分别为0.9%、17.3%,2组之间差异有统计学意义(χ2=18.953,P<0.05)。观察组和对照组肠道病毒EV71感染率分别为1.6%、17.7%,2组之间差异有统计学意义(χ2=40.1,P<0.05)。多因素分析结果显示只有是否接种疫苗为影响因素,接种疫苗为保护因素,接种疫苗者感染EV71的可能性是不接种者的0.032倍。结论2016年接种肠道EV71灭活疫苗后,昆明市妇幼保健院就诊手足口病患儿中肠道病毒EV71病原构成比有下降,接种疫苗者感染EV71的可能性较不接种者小,疫苗接种对肠道病毒EV71感染引起的手足口病有很好的预防作用。Objective To observe the variation of pathogen composition of hand-foot-and-mouth disease(HFMD)in maternal and child health hospital of Kunming before and after enterovirus 71(EV71)vaccination,investigate the immune protection of EV71 vaccination after been vaccinated so as to provide clinical objective basis for the promotion of EV71 vaccination.Methods It took 2016 as the demarcation point for vaccine use,the children were diagnosed with HFMD in 2014 and 2015 in Kunming maternal and child health hospital,who had finished the etiological examination were selected as the control group,the children who were diagnosed with HFMD in 2017 and 2018 had finished the etiological examination were selected as the observation group.Compared the infection rates of EV71 between the two groups;At the same time,whether infected EV71 as the dependent variable,vaccination or not,gender and age as independent variables to conducted multiple-factor analysis.Results The infection rates of EV71 in the boy observation group and the boy control group were 2.1%and 18%.There was statistical significance in differences between the two groups(χ2=21.269,P<0.05).The infection rates of EV71 in the girl observation group and the girl control group were 0.9%and 17.3%,there was statistical significance in differences between the two groups(χ2=18.953,P<0.05).The infection rates of EV71 in observation group and the control group was 1.6%and 17.7%,respectively.There was statistical significance in differences between the two groups(χ2=40.1,P<0.05).The results of multi-factor analysis showed that only vaccination as the influencing factor and the protective factor.Vaccine recipients were 0.032 times more likely to be infected with EV71 than non-vaccinated persons.Conclusions After the intestinal EV71 inactivated vaccine was administered in 2016,the composition ratio of enteroviruses EV71 in children with HFND treated in Kunming maternal and child health hospital decreased.Those who were vaccinated were less likely to be infected with EV71.It has

关 键 词：手足口病 肠道病毒EV71 病原学 病原构成 感染率 

分 类 号：R183.4[医药卫生—流行病学]