山东省EV71和CoxA16所致手足口病重症病例流行病学及临床特征分析

目的比较EV71和CoxA16所致手足口病重症病例临床症状和体征,为手足口病的诊疗和防控提供依据。方法采用实时荧光定量RT-PCR对重症病例进行病原学分型;收集病例基本信息和临床资料,对2010年确诊的EV71和CoxA16所致手足口病重症病例的临床特征进行比较分析。结果 EV71与CoxA16所致手足口病重症患者主要为3岁以下儿童(占81.61%),患者平均年龄为2.30岁(0.20～16.39岁)。EV71所致重症患者最高体温为(38.75±0.04)℃,CoxA16所致重症患者为(38.60±0.07)℃,差异无统计学意义(t=-1.61,P>0.05);两种病毒所致重症患者口腔部位皮疹、咳嗽、流涕和心率加快发生率差异均有统计学意义(P<0.05),其他症状和体征均一致。结论 CoxA16与EV71所致重症手足口病患者临床特征基本一致,均引起严重并发症。应加强对CoxA16感染的监测和防控。

The epidemiological and clinical characteristics of severe cases of hand,foot and mouth disease (HFMD) caused by EV71 and CoxA16 in Shandong Province

Objective To analyze the differences in the clinical characteristics of severe cases of HFMD caused by EV71 and CoxA16 so as to provide a scientific basis for the diagnosis,treatment,and prevention of HFMD.Methods The pathogenic subtypes of the severe cases were determined with real-time quantitative RT-PCR,and clinical information was collected by a case investigation.Differences in the clinical characteristics of severe HFMD cases caused by EV71 and CoxA16 were comparatively analyzed.Results Severe cases of HFMD caused by EV71 and CoxA16 were mainly in children under 3 years of age(accounting for 81.61% of patients);patients had an average age of 2.30 years(0.20-16.39 years).Patients with severe HFMD caused by EV71 had a mean maximum temperature of(38.75±0.04) ℃;patients with severe HFMD caused by caused by CoxA16 had a maximum temperature of(38.60±0.07) ℃.There were no significant differences between the two groups(t=-1.610,P>0.05).The clinical features of severe cases of HFMD caused by these two viruses differed significantly in terms of a rash in the mouth,cough,runny nose,and rapid heartbeat.Conclusion There were no significant differences in the clinical characteristics of severe cases of HFMD caused by EV71 and CoxA16.Both CoxA16 and EV71 can cause serious complications.Surveillance and control of CoxA16 infection should be enhanced.