2010-2013年梧州市手足口病病原学特征分析

摘要:目的　分析2010-2013年间梧州市手足口病的病原学监测结果，探讨病毒流行特征，为今后制定预防及控制防治策略提供依据。方法　采用RT-PCR法对1 835例手足口病临床诊断病例的肛拭子样本进行核酸检测，用SPSS对数据进行统计分析。结果　1 835例手足口病病例的肛拭子样本中，EV71、CoxA16、其他类型的EV的总检出阳性率分别为28.55%、26.75%、45.83%；病毒优势流行株由2010年以EV71为优势毒株逐渐转变成2013年以其他类型的EV为优势毒株；普通与重症病例的检出阳性率的差异有统计学意义（χ2＝491.54，P＜0.001），不同病毒类型在普通与重症病例间的构成的差异有统计学意义（普通与重症病例间的构成比总体比较的χ2为26.34，普通与重症病例间其他类型的EV构成比较χ2为120.61，EV71为219.98，CoxA16为48.67，均为P＜0.001）；以5岁内婴幼儿的肠道病毒阳性检出为主（总肠道病毒检出率构成比为90.91%）。结论　EV71更易导致重症，但致死亡的风险与其他病毒相同；病毒的优势流行株改变是否与气候相关并影响发病值得进一步研究；5岁以下儿童，特别是3岁以下的儿童为防止手足口病进展为重症、死亡病例时需重点关注的人群。

The pathogen surveillance of the Hand foot and mouth disease (HFMD) in Wuzhou City, 2010-2013

Abstract: Objective To analyze the pathogen surveillance of the Hand foot and mouth disease (HFMD) during 2010～2013 in Wuzhou City, to find the epidemiological characteristics of those virus, and to provide the bases for the prevention and control strategies of HFMD. Methods Real-time polymerase chain reaction (RT-PCR) assay was employed to detect nucleic acid in 1835 cases diagnosed HFMD, and the data was analyzed with SPSS. Results The positive rates of the EV71, CoxA16 and the other EV were 28.55%, 26.75% and 45.83%, respectively; in recent years the trend of the detectable rate of virus suggested that the epidemic strain changed every year. From 2010 to 2013, the dominant strain gradually changed from EV71 to the other EV; the positive rates between the general and the severe cases were different (χ2=491.54, P<0.0001). Different types of viruses between the general and the severe cases were different (χ2 of comparison of the difference between the general and the severe cases is 26.34: χ2 of the other EV between the general and the severe cases is 120.61. χ2 of the EV71 is 219.98, and χ2 of the CoxA16 is 48.67, all P<0.0001; Children under five are the main population of positive cases (90.91%). Conclusion EV71 may be more likely to cause severe cases, but the risk of death is same as the other virus; Whether the change of the virus strains related to the climate is worth further studying; children under 5 particularly under 3 are the focus of HFMD prevention and control.