排除流感的儿童流感样病例肠道病毒核酸检测分析

目的为了解排除流感的儿童流感样病例的肠道病毒感染状况，以减少对手足口病患儿的误诊，提高儿童流感样病例（Iu）标本的采集质量。方法随机抽取88份已排除流感的儿童流感样病例标本，以实时荧光RT—PCR法进行人肠道病毒（Ev）核酸检测并分型。对Ev核酸阳性率按季节、年龄、性别和采样人进行分类统计分析。结果检出EV71型核酸阳性6份、CoxA6型2份．CoxAl0型1份、其它型别17份，EV核酸总阳性率为29．55％（26／88）。Ev核酸阳性率由高到低的季节依次为：2012年第四季度（47．83％）、2013年二季度（40．00％）、2012年三季度（20．83％）和2013年一季度（9．52％）。5岁以下与6岁以上病例标本的EV核酸阳性率依次为36．76％（25，68）和5．00％（1／20）。男女病例标本的EV核酸阳性率分别为30．91％（17／55）和27．27％（9／33）。医生与护士采集标本的Ev核酸阳性率分别为9．09％（3／33）和41．82％（23／55）。结论儿童流感样病例应同手足121病进行鉴别诊断，流感监测哨点医院应提高病例的样本采集质量。

Ditection of nucleic acid of enterovirus in children with influenza like illness except influenza.

Objective To understand hand-foot-mouth disease （HFMD）infection status in children with influenza like illness （ILl）excluded influenza. Methods The 88 samples of ILl children excluded influenza were detected for the enterovirus （EV）nueleie acid and type by Real-time RT-PCR, the EV positive rate was analysed by season, age, gender and collection person. Results Six eases were positive for EV71,2 were positive for CoxA16,one was positive for CoxA10 and 17 were positive for other types.The total positive rate of EV was 29.55%（26/88）. The EV positive rate from high to low winter in 2012（47.83%）, the summer in 2013 （40.00%）,the autumn in 2012（20.83%）and the spring in 2013 （9.52%）.The positive rate of the samples below 5 years and above 6 years were 36.76%（25/68）and 5.00%（1/20）. EV positive rate in male and female samples were 30.91%（ 17/55）and 27.27% （9/33）.The EV positive rate of the samples collected by doctor and nurse were 9.09% （3/33）and 41.82% （23/55）. Conclusions The diagnosis of child ILI and HFMD should be differentiated and the sampling quality collected in sentinel hospitals be enhanced.