70例手足口病病原检测和临床分析

目的 分析研究70例手足口病患者的临床一般情况及其致病原.方法 采集70例手足口病患者(其中5岁以下儿童患者60例)的咽拭子标本,提取病毒RNA.用逆转录聚合酶链反应(RT-PCR)一步法检测肠道病毒(EV)的5'-UTR区基因、肠道病毒71型(EV71)的Vp3～Vp1区基因、柯萨奇病毒A16(Cox-A16)的Vp3～Vp1区基因.结果 在70例手足口病患者中,咽拭子标本肠道病毒核酸阳性率为42.8%(30/70).在30例肠道病毒核酸阳性病原中,EV71占66.7%(20/30).5岁以下儿童有EV71肠道病毒、或Cox-A16病毒、或非EV71及非Cox-A16的其他肠道病毒感染病例.而5岁以上的儿童和成人患者则只有EV71肠道病毒感染病例.39例4 d内采集的咽拭子标本病原核酸阳性检测率平均为66.7%(26/39),31例5 d以后采集的标本病原核酸阳性检测率是12.9%(4/31),差异有统计学意义(x~2=20.4,P<0.01).结论 手足口病以0～5岁婴幼儿患病为主,但成人也可发病.用RT-PCR检测病原核酸阳性的手足口病患者以EV71为主,且以发病后4 d内阳性检测率高.

The etiology and clinical manifestations of 70 patients with hand-foot-mouth disease

Objective To analyze the etiology and clinical manifestations of 70 patients with hand-foot-mouth disease (HFMD). Methods The viral RNA from the pharynx swab samples were extracted and collected from 70 HFMD patients (of which,60 cases were under 5 years old) to detect the 5'-UTR gene of EV,the Vp3-Vp1 genes of EV71 and Cox-A16 by utilizing the technique of RT-PCR. Results Of 70 HFMD patients,30 cases (42.8%, 30/70) were positive in enterovirus nucleic acid, including EV71 and Cox-A16,pharynx swab sample testing. While, of the enteroviral pathogen RNA-positive 30 cases, EV71 accounted for 66. 7% (20/30). The proportion of etiological positive of 39 samples collected within 4 days after onset was 66.7% (26/39), but the probability of 31 samples collected after more than 5 days after onset was 12.9%(4/31),the difference was significantly(x~2=20.4,P<0. 01). Conclusion HFMD patients were mainly infants and young children between 0-5 years old, but adults could also be attacked. The enterovirus detected was mainly EV71,and the pharynx swab samples should be collected within 4 days after onset to increase the related viral nucleic acid positive detection probability.