2020—2021年芜湖市某三甲医院手足口病流行病学特征及病原学检测结果分析

  目的  分析2020-2021年芜湖市某三甲医院手足口病流行病学和病原学特征, 为本市制定手足口病防控策略提供参考依据。  方法  对2020年1月-2021年12月芜湖市第一人民医院的200例手足口病样本进行流行病学分析, 利用实时荧光定量PCR法进行病原学检测。  结果  200例手足口病病例中, 男女性别比为1.9:1;3岁以下散居患儿占比最高(81.0%), 为该疾病的高发人群。2020-2021年手足口病病原体以柯萨奇病毒A16型(CoxA16)和肠道病毒71型(EV71)为主, 其例数和占比分别为96例(48.0%)和90例(45.0%), 呈现共同流行态势。从标本检出率方面看, 咽拭子检出率最高(38.5%), 疱疹液检出率最低(29.0%), 但不同标本病毒检出率差异无统计学意义(P>0.05)。200例患儿中, 133例为普通型(66.5%), 67例重症型(33.5%)。与普通组比较, 重症患儿体温>39℃、心律失常、急躁、肢体抖动、颈项强直等症状的发生率明显增加(均P < 0.05)。  结论  手足口病在不同人群、时间、地区上的分布具有一定差异性。CoxA16和EV71型肠道病毒型已成为本辖区手足口病的优势病毒型别。应进一步加强手足口病病原学监测, 同时要进行相关知识的宣教, 提高医师对病例表现的识别能力。 

Analysis of the epidemiological characteristics and pathogenic detection results of hand,foot and mouth disease in a tertiary hospital in Wuhu City from 2020 to 2021

  Objective  To analyse the epidemiological and pathogenic characteristics of hand, foot and mouth disease in a tertiary hospital in Wuhu City from 2020 to 2021 and to provide a reference for the city to formulate prevention and control strategies for hand, foot and mouth disease.  Methods  Epidemiological analysis was performed on 200 samples of hand, foot and mouth disease, and pathogenic detection was performed by real-time fluorescent quantitative PCR.  Results  In 200 cases of hand, foot and mouth disease, the male-to-female ratio was 1.9:1.Scattered children under 3 years of age accounted for the highest proportion of the total number of people, and 81.0% were at high risk of contracting the disease.From 2020 to 2021, the pathogens of hand, foot and mouth disease in this city were mainly CoxA16(96 cases, 48.0%) and EV71(90 cases, 45.0%), showing a common epidemic situation.In terms of detection rate, throat swabs were the highest (38.5%), and herpes fluid was the lowest (29.0%).However, the detection rates of various viruses were relatively close (P>0.05).Among the 200 cases, 133 cases were normal type (66.5%) and 67 cases were severe syndrome type (33.5%).Compared with the normal type, the incidence of symptoms such as body temperature>39℃, arrhythmia, impatience, limb shaking and neck stiffness in severe group were significantly increased (all P < 0.05).  Conclusion  The distribution of hand, foot and mouth disease has certain differences in different populations, times and regions.CoxA16 and EV71 enterovirus types have become the dominant virus types of hand, foot and mouth disease.Therefore, it is necessary to further strengthen its pathogenic monitoring, and at the same time conduct related knowledge education to improve the doctor's ability to identify case manifestations.