2018-2022年西安单中心儿童手足口病流行病学及病原学特征分析  

Epidemiological and etiological characteristics of hand⁃foot⁃and⁃mouth disease in children in a single center in Xi'an during 2018-2022

作　　者：陈芸 彭程 赵凤兰[1] 李淑娟 张华[1] CHEN Yun;PENG Cheng;ZHAO Fenglan;LI Shujuan;ZHANG Hua(Department of Pediatrics,the First Affiliated Hospital of Xi'an Medical University,Xi'an,Shaanxi 710077,China;Department of Infection Control,the First Affiliated Hospital of Xi'an Medical University,Xi'an,Shaanxi 710077,China)

机构地区：[1]西安医学院第一附属医院儿科,陕西西安710077 [2]西安医学院第一附属医院感染控制科,陕西西安710077

出　　处：《热带医学杂志》2024年第9期1330-1333,1338,共5页Journal of Tropical Medicine

基　　金：陕西省科技厅一般项目—社会发展领域(2022SF-553)。

摘　　要：目的探讨2018-2022年西安单中心儿童手足口病的流行病学及病原学特征,为进一步推进手足口病防控工作提供科学依据。方法回顾性分析2018年1月-2022年12月西安医学院第一附属医院儿童手足口病流行病学和病原学资料,进行描述性统计学分析。结果2018-2022年共收治儿童手足口病625例,发病人数呈逐年下降趋势;男女性别比为1.43∶1,男性患者多于女性,但各年份间性别比差异无统计学意义(χ^(2)_(趋势)=3.389,P>0.05);患者主要集中在5岁以下儿童(91.52%),尤其是0~<1岁年龄段儿童(33.60%),各年龄段发病差异有统计学意义(χ^(2)=70.358,P<0.05);发病主要集中在7、11月,全年各月发病差异有统计学意义(χ^(2)=567.889,P<0.05)。手足口病病原学检测阳性220例,阳性率为35.20%;阳性标本中柯萨奇B组病毒(CVB)、柯萨奇病毒A16型(CA⁃16)、肠道病毒71型(EV71)构成比分别为51.13%、30.83、18.05%;2018、2019、2021年以肠道病毒CVB感染为主,2020、2022年以CA⁃16感染为主,各年份间不同肠道病毒感染和各肠道病毒感染的不同年份间差异均有统计学意义(P均<0.05)。结论本地区手足口病防控重点应放在5岁以下儿童,以及夏、冬季节。对于手足口病感染病原,除既往较为关注的EV71、CA⁃16外,CVB及其他肠道病原监测亦不能忽略,应根据流行病学特征及预测的发病趋势,有针对性地做好手足口病防控工作。Objective To investigate the epidemiological and etiological characteristics of hand⁃foot⁃and⁃mouth disease(HFMD)in children,and provide scientific basis for further prevention and control of HFMD.Methods The epidemiological and etiological data of HFMD in children in the First Affiliated Hospital of Xi'an Medical University from January 2018 to December 2022 were retrospectively analyzed,and descriptive statistical analysis was performed.Results From 2018 to 2022,a total of 625 children with HFMD were treated in our hospital,and the number of patients showed a decreasing trend year by year.The incidence of man to woman was 1.43∶1,but there was no significant difference in sex ratio among different years(χ^(2)_(trend)=3.389,P>0.05).The patients were mainly children under 5 years of age,especially children 0~<1 years of age(33.60%),and the incidence difference was statistically significant among all age groups(χ^(2)=70.358,P<0.05).The incidence was mainly concentrated in July and November,and the monthly incidence difference was statistically significant(χ^(2)=567.889,P<0.05).There were 220 cases with positive HFMD etiology,the positive rate was 35.20%.The constituent ratio of coxsackievirus B(CVB),coxsackievirus A16(CA⁃16)and enterovirus virus 71(EV71)were 51.13%,30.83%and 18.05%,respectively.In 2018,2019 and 2021,the infection of enterovirus CVB was the most common one,and in 2020 and 2022,the infection of CA⁃16 was the most common one,there were significant differences in enterovirus infection and enterovirus infection between different years(all P<0.05).Conclusions The prevention and control of HFMD in the region should focus on children under the age of 5,as well as summer and winter festivals.For pathogens of HFMD infection,in addition to EV71 and CA⁃16,which have been paid more attention in the past,CVB and other intestinal pathogens should not be ignored.Prevention and control of HFMD should be targeted according to the epidemiological characteristics and predicted incidence trend.

关 键 词：手足口病 流行病学 病原学 疫情防控 

分 类 号：R512.5[医药卫生—内科学]