保定市手足口病重症病例分析

目的探讨手足口病重症病例的病原学和流行病学特征,为重症病例的防治提供实验室依据。方法采用荧光RT-PCR法对手足口病患者咽拭子标本进行肠道病毒通用型、肠道病毒71型（EV71）、柯萨奇病毒A组16型（CoxA16）核酸检测,用SPSS 11.5软件进行统计学分析。结果重症病例肠道病毒阳性检出率和EV71病原构成比显著高于普通病例,其中并发肺水肿的重症病例,EV71阳性检出率最高,为54.84%。在实验室确诊病例中,重症病例构成比在男女性别上无差异,而EV71阳性病例构成比男孩低于女孩。年龄越小,重症病例越易发生,EV71阳性病例构成比在年龄上无差异。重症确诊病例发病高峰出现在5—7月,但重症确诊病例和EV71阳性病例在确诊病例中的构成比高峰则出现在8、9月。重症确诊病例多集中于南部和中部,而EV71阳性病例在确诊病例中的构成比以北部最高,为56.61%。结论 EV71为重症病例的主要病原体,但重症确诊病例和EV71阳性病例在流行病学分布特征上有差异,加强低年龄组儿童在5—9月的防控,可有效降低手足口病重症病例的发生。

Analysis on severe cases of hand-foot-mouth disease in Baoding City

Objective] To explore the pathogenic and epidemiological characteristics of the severe cases of hand-foot-mouth disease （ HFMD ）, provide experimental evidence for prevention and control of HFMD. Methods ] The fluorescence RT-PCR was used to detect the nucleic acid of universal enterovirus, enterovirus 71 （EV71） and coxsackievirus 16 （CoxA16） in throat swabs from HFMD patients, and the software SPSS11.5 was applied in the statistical analysis. Results] The detection rate of enterovirus and the constituent ratio of EV71 in severe cases were significantly higher than those in common cases. The detection rate of EV71 in severe eases with pulmonary edema was highest, which accounted for 54.84%. Among laboratory diagnosed eases, there was no significant difference in the constituent ratio of severe cases between males and females, but the constituent ratio of EV71 positive cases in boys was lower than that in girls. The younger children were prone to get severe HFMD, but there was no significant difference in the constituent ratio of EV71 positive cases among different age groups. Most of diagnosed severe cases occurred May to July, but the number of severe cases and the constituent ratio of EV71 positive cases reached the peak from August to September. The severe cases were mainly distributed in the southern and central regions. However, the constituent ratio of EV71 positive cases in northern region was highest, which accounted for 56.61%. Conclusion] EV71 is the major pathogen for severe cases of HFMD, but the epidemiologieal characteristics of laboratory-diagnosed severe cases is different from that of EV71 positive cases. To strengthen the control and prevention among younger children from May to September can effectively reduce the incidence of severe HFMD cases.