其他型别肠道病毒感染手足口病患儿病毒排泌时间分析

目的了解非肠道病毒71型(EV71)非柯萨奇病毒16型(CA16)肠道病毒(其他型肠道病毒)感染手足口病患儿的排毒时间,以及重组人IFNα2b喷雾剂干预治疗对其排毒时间的影响。方法收集2016年12月至2017年12月杭州市儿童医院收治住院的其他肠道病毒感染手足口病患儿共159例,在入院2 d内同时采集患儿粪便和咽拭子样本,通过荧光定量PCR法进行病毒检测。对实验室确诊资料完整的87例患儿咽部及肠道排毒情况进行追踪和随访,实验组采用重组人IFNα2b喷雾剂干预治疗(52例),对照组用开喉剑喷雾剂治疗(35例),观察两组病毒转阴情况。结果159例患儿治疗第1周时粪便病毒核酸检测均为阳性,第2周时出现转阴病例,至第6周全部转阴。重组人IFNα2b喷雾剂干预治疗对其他肠道病毒型手足口病5~7 d咽部排毒的累计转阴率为54.0%,高于对照组的40.0%,但差异无统计学意义(χ^2=1.382,P>0.05);两组肠道病毒累计转阴率比较差异无统计学意义(χ^2=0.131,P>0.05)。结论其他肠道病毒感染手足口病患儿第2周出现肠道病毒转阴。重组人IFNα2b喷雾剂干预治疗一定程度略提高咽部排毒转阴率。

Effects of different interventions on virus detoxification in patients with hand,foot and mouth disease caused by other enterovirus infection

Objective To understand the pharyngeal and intestinal detoxification time of hand,foot and mouth disease caused by non-enterovirus 71 and non-coxsackievirus A16 enteroviruses(other EV),and the effect of recombinant human interferonα2b spray on its detoxification time.Methods The data of 159 children with hand,foot and mouth disease caused by other EV infection who were admitted in Hangzhou Children’s Hospital from December 2016 to December 2017 were selected.The stools and pharynx were collected within 2 days after admission,and tested for virus by real-time PCR.The pharyngeal and intestinal detoxification situation of 87 patients with complete diagnosis were followed up.The experimental group was treated with recombinant human interferonα2b spray(52 cases),and the control group was treated with Kaihoujian spray(35 cases).The cumulative conversion rate of two groups were observed.Results The fecal virus nucleic acid in 159 patients were all positive at the first week of treatment,and negative cases occurred at the second week.By the sixth week,all the fecal virus nucleic acid were negative.The cumulative negative rate of pharyngeal detoxification for hand,foot and mouth disease caused by other EV was 54.0%,which was higher than that of the control group(40.0%),but the difference was not statistically significant(χ^2=1.382,P>0.05).There was no significant difference in the cumulative negative rate of enterovirus between the two groups(χ^2=0.131,P>0.05).Conclusions Enterovirus turns negative in hand,foot and mouth disease children caused by other EV infections in the second week.Recombinant human interferonα2b spray treatment slightly improved the pharyngeal detoxification rate.