2015-2018年贵州省铜仁市手足口病病原学特征分析

目的 分析2015-2018年间贵州省铜仁市手足口病的病原学特征，为今后制定防控措施提供依据。方法 采用RT-PCR 法对3 287例手足口病临床诊断病例的咽拭子样本进行核酸检测，用SPSS20.0软件对数据进行统计分析。结果 3 287例手足口病咽拭子标本中， EV71型、CoxA16型、CoxA6型、CoxA10型总检出阳性率分别为25.56%、22.27%、12.02%和9.89%；轻症病例检出阳性率75.56%（1 845/2 442）高于重症病例52.90%（447/845）（χ2＝152.335，P＜0.01），重症手足口病例检出EV71型最多，占重症阳性标本的48.09%（215/447）；每年1-12月均有手足口病病例发生，发病高峰在5-7月，占病例总数的72.80%（2 393/3 287）；贵州省铜仁市10区（县）病例数排前三位分别是碧江区（11.19%）、玉屏县（11.04%）和德江县（10.62%），沿河县病例数最少（9.07%）；发病年龄集中在6岁以下，占92.97%（3 056/3 287）。其中1～3岁年龄段发病占总发病数的68.09%（2 238/3 287）；男、女发病比为1.28∶1，男性病原构成比56.16%（1 846/3 284)与女性43.84%（1 441/3 284)比较差异无统计学意义（χ2=1.376，P=0.297）。结论 贵州省铜仁市手足口病病原以EV71型和CoxA16型为主，CoxA6型、CoxA10型构成比逐渐上升； EV71型是引起重症病例的主要病原，应重点防控。

Pathogen surveillance of the hand-foot-and-mouth disease in Tongren City, 2015-2018

To analyze the pathogen surveillance of the Hand foot and mouth disease(HFMD) during 2015-2018 in Tongren City, and 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 3287 cases diagnosed HFMD, and the data was analyzed with SPSS. Results The positive rates of the EV71, CoxA16, CoxA6, CoxA10 were 25.56%, 22.27%, 12.02% and 9.89% respectively. The positive rate of mild cases was 75.56%(1845/2 442) higher than severe cases 52.90%(447/845)(X2=152.335, P<0.01). The severe cases detected EV71, accounting for 48.09%(215/447). HFMD cases occur from January to December every years. The peak incidence was from May to July accounting for 72.80%(2 393/3 287). The top three cases in the 10 districts(counties) of Tongren City, Guizhou Province are Bijiang District(11.19%), Yuping County(11.04%) and Dejiang County(10.62%),with the least cases(9.07%) in Yanhe County. The age of illness which is mainly under 6 years old was 92.97%(3 056/3 287), and the age of 1-3 years is the most common, accounting for 68.09%(2 238/3 287). The ratio of male to female was 1.28∶1. The proportion of male pathogens was 56.16%(1 846/3 287) and the proportion of female pathogens was 43.84%(1 441/3 284). There was no significant difference in the proportion of pathogens between male and female(X2=1.376, P=0.297). Conclusion HFMD in Tongren City of Guizhou Province shows EV71 and CoxA16 are the main pathogens. The composition ratio of CoxA6 and CoxA10 is increasing gradually. EV71 is the main pathogen causing severe cases and should be focused on prevention and controlled.