2016—2018年上海某医院手足口病流行病学特征及病原学监测结果研究  

Study on epidemiologic characteristics and monitoring results of etiology in hand-foot-mouth disease in a hospital of Shanghai during 2016-2018

作　　者：胡海贇 蔡明毅[2] 葛玮[3] 李晓露 乔蓉[1] HU Haiyun;CAI Mingyi;GE Wei;LI Xiaolu;QIAO Rong(Department of Infection,Shanghai Municipal Children′s Hospital/Affiliated Children′s Hospital,Shanghai Jiaotong University,Shanghai 200333,China;Jing′an District Center for Disease Control and Prevention,Shanghai 200072,China;Department of Prevention and Health Care,Shanghai Municipal Children′s Hospital/Affiliated Children′s Hospital,Shanghai Jiaotong University,Shanghai 200333,China)

机构地区：[1]上海市儿童医院/上海交通大学附属儿童医院感染科,上海200333 [2]上海市静安区疾病预防控制中心,上海200072 [3]上海市儿童医院/上海交通大学附属儿童医院防保科,上海200333

出　　处：《检验医学与临床》2023年第1期4-8,共5页Laboratory Medicine and Clinic

基　　金：国家自然科学基金青年科学基金项目(81900472)。

摘　　要：目的了解手足口病不同病原体的感染现状及手足口病的流行病学特点,为做好手足口病防控工作提供参考。方法收集2016—2018年在上海市儿童医院感染科门诊诊断为手足口病的患儿资料进行流行病学分析。采集部分病例的咽拭子、肛拭子标本进行病原学检测。采用反转录聚合酶链反应(RT-PCR)对肠道病毒71型(EV71)、柯萨奇病毒A组16型(CVA16)、柯萨奇病毒A组6型(CVA6)、柯萨奇病毒A组10型(CVA10)、其他肠道病毒(PE)进行鉴别。结果20104例手足口病患儿共采集778份标本(咽拭子389份、肛拭子389份),667份标本检测病毒阳性,检出率为85.73%。2016—2018年各年手足口病病原体的总检出率差异无统计学意义(P>0.05);与2016年比较,2018年EV71的检出率明显下降,CVA6的检出率显著增加,差异有统计学意义(P<0.05);3年患儿的性别构成差异无统计学意义(P>0.05);3年中本市户籍患儿数占比最高,且有逐年增高的趋势;3年的月度病例报告数统计发现,流行高峰通常在每年的5—8月;EV71、CVA16大致在每年的1—6月流行,CVA6流行季节在每年的7—12月。结论上海市儿童医院手足口病的不同病原体在不同年份呈现不同的流行特征,对手足口病流行病学特征的分析、比较有助于对疾病的防控、早期治疗、重症病例的筛查。Objective To understand the infection status quo of different pathogens and epidemiologic characteristics in hand-foot-mouth disease(HFMD)to provide reference for doing its prevention and control work well.Methods The data of the children patients with HFMD diagnosed in the outpatients Department of Infection of Shanghai Municipal Children′s Hospital during 2016-2018 were collected to conduct the epidemiologic analysis.The anal and throat swab samples from partial cases were collected for conducting the etiologic detection.The RT-PCR assay was adopted to identify Enterovirus 71(EV71),Coxsackie A16(CVA16),Coxsackie A10(CVA10)and other enteroviruses.Results Among 20104 children cases of HFMD,778 samples were collected(throat swabs 389 cases and anal swabs 389 cases),and 667 samples were detected the virus positive with a detection rate of 85.73%.The total detection rate of HFMD pathogens in each year during 2016-2018 had no statistical difference(P>0.05);comparison with those in 2016,the detection rate of EV71 in 2018 was decreased significantly,the detection rate of CVA6 was increased significantly,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the gender composition of the children patients during 3 years(P>0.05);the proportion of the children patients with household registration in this city was the highest in these 3 years,moreover which showed the increasing trend year by year;the number of monthly cases reports in these 3 years found that the epidemic peak of onset was usually in May to August each year.EV71 and CVA16 were prevalent from January to June.The prevalent seasons of CVA6 were July to December in each year.Conclusion The different pathogens of HFMD in Shanghai Municipal Children′s Hospital show different epidemic characteristics in different years.Analyzing and comparing the characteristic of HFMD epidemiology is helpful to prevent and control the disease,early treatment and screening of severe cases.

关 键 词：手足口病 肠道病毒 流行病学特征 

分 类 号：R512.5[医药卫生—内科学]