502例手足口病患儿实验室检测结果的分析

目的观察手足口病患儿的实验室检测结果,并探讨其意义。方法收集502例(重症型104例,轻症型398例)手足口病住院患儿的咽试子标本,采用实时荧光聚合酶链反应(RT-PCR)法对手足口病患儿肠道病毒通用型(EV)、肠道病毒71型(EV71)以及柯萨奇病毒A组16型(CA16)核酸进行检测。同时检测白细胞(WBC)、直接胆红素(DBIL)、丙氨酸氨基转移酶(ALT)、肌酸激酶同工酶(CK-MB)及乳酸脱氢酶(LDH)并进行分析。结果 502例手足口病患儿中,EV、EV71、CA16感染阳性分别为384例(76.49%)、262例(52.19%)、39例(7.76%)。男性患儿多于女性患儿,104例重症型手足口病患儿中,EV71阳性率为92.31%;502例手足口病患儿中有402例3岁。104例重症型患儿有97例(93.27%)3岁;其中EV71阳性率92.78%(90/97)。重症型与轻症型相比,重症型手足口病患儿WBC、LDH、CK-MB、DBIL和ALT水平较高(P0.05)。结论手足口病患儿以3岁为主,感染的肠道病毒主要为EV,引起重症型的主要病原体为EV71。

Analysis on the laboratory determination results of 502 patients with hand-foot-mouth disease

Objective To analyze the laboratory determination results of hand-foot-mouth disease(HFMD)and explore its sig-nificance.Methods Pharyngeal swab specimens were collected from 502 children with HFMD(severe case:104 cases and mild case:398 cases).Specific RNA of enterovirus primer(EV),enterovirus71 (EV71)and coxsackievirus A16(CA16)were detected by real-time fluorescence polymerase chain reaction(RT-PCR).Simultaneously,white blood cell (WBC),direct bilirubin(DBIL),alanine transarninase(ALT),creatine kinase MB isoenzyme(CK-MB)and lactic dehydrogenase (LDH )were determined,and the results were analyzed.Results Among the 502 children,384 cases were positive for EV,262 cases were positive for EV71,and 39 cases were positive for CA16.The positive rates were 76.49%,52.19% and 7.76%,respectively.In the 104 HFMD severe cases,EV71 positive rate was 92.31%(96/104).There were clearly more boys than girls.The age distribution was mainly in the group under 3-year-old(402 cases,80.08%).In the group under 3-year-old,there were 97 severe cases(93.27%),and the EV71 positive rate was 92.78%(90/97).Serum levels of WBC,DBIL,ALT,CK-MB and LDH were higher in severe HFMD group than in mild group(P <0.05).Conclusion The HFMD occurred mostly at the children under 3-year-old.The HFMD appeared is mainly related to the EV infection,and EV71 is the main pathogen causing the severe cases of HFMD.