德阳地区手足口病病原谱分析及EV71血清学流行病学特征  

Serological epidemiological characteristics of EV71 and pathogen spectrum of hand,foot and mouth disease in Deyang

作　　者：李觅 陈忠萍 杨欣颖 LI Mi;CHEN Zhong-ping;YANG Xin-ying(Department of Infectious Diseases,Deyang People′s Hospital,Deyang,Sichuan 618000,China)

机构地区：[1]四川省德阳市人民医院感染科,四川德阳618000

出　　处：《公共卫生与预防医学》2022年第5期144-147,共4页Journal of Public Health and Preventive Medicine

摘　　要：目的探究德阳地区手足口病(HFMD)病原谱及肠道病毒71型(EV71)血清学流行病学特征。方法对2019年6月至2021年6月德阳地区287例HFMD患者的一般临床资料和病原学资料进行统计学分析,采集患者血液样本,采用中和试验检测血清EV71中和抗体。结果287例HFMD患者中,危重型患者多集中在1~6岁,不同年龄段患者临床分型比较,差异有统计学意义(P<0.05)。共检出EV阳性254例(88.50%),其中EV71阳性131例(45.64%),CVA16阳性98例(34.15%),其他EV阳性25例(8.71%);危重型患者的EV71阳性率较高(P<0.05)。EV71抗体阳性率在<1岁~>15岁患者中逐渐升高,不同年龄患者EV71抗体阳性率比较,差异有统计学意义(P<0.05)。287份血清标本中,中和抗体滴度<1∶8的有156份(54.36%),1∶8~1∶32的有86份(29.97%),>1∶32的有45份(15.68%)。EV71中和抗体滴度>1∶32患者以>15岁为主,不同年龄患者EV71中和抗体滴度比较,差异有统计学意义(P<0.05)。结论不同临床分型患者EV阳性率存在差异,EV71、CVA16病毒是德阳地区HFMD流行的主要病原体;6岁以下HFMD患者EV71抗体水平较低,建议加强6岁以下儿童EV71疫苗接种工作。Objective To explore the pathogen spectrum of hand,foot,and mouth disease(HFMD)in Deyang,and the serological epidemiological characteristics of enterovirus 71(EV71).Methods The general clinical data and etiological data of 287 patients with HFMD in Deyang from June 2019 to June 2021 were statistically analyzed.Blood samples were collected to detect serum EV71 neutralizing antibodies by neutralization test.Results Among the 287 patients with HFMD,most of the critically ill patients were between 1 and 6 years old.There was a statistically significant difference in clinical classification between different age groups(P<0.05).A total of 254(88.50%)EV-positive cases were detected,including 131(45.64%)positive for EV71,98(34.15%)positive for CVA16,and 25(8.71%)positive for other EVs.The EV71 positive rate was higher in critically ill patients(P<0.05).The positive rate of EV71 antibody increased with age within 15 years old,with statistically significant differences among different age groups(P<0.05).Among the 287 serum samples,there were 156(54.36%)samples with neutralizing antibody titer<1∶8,86(29.97%)with titer between 1∶8 and 1∶32,and 45(15.68%)with titer>1∶32.Patients with EV71 neutralizing antibody titer>1∶32 were over 15 years old.There were statistically significant differences in EV71 neutralizing antibody titer between different age groups(P<0.05).Conclusion The positive rate of EV is different in patients with different clinical types.EV71 and CVA16 are main pathogens of HFMD in Deyang.HFMD patients under 6 years old have lower EV71 antibody level.It is recommended to strengthen EV71 vaccination for children under 6 years old.

关 键 词：手足口病 病原谱 肠道病毒71型 

分 类 号：R181[医药卫生—流行病学]