CAJ | 학술논문

目的探讨肠道病毒71型(enterovirus 71,EV71)感染重症手足口病患儿的临床特征及病原的基因型.方法采用荧光定量PCR方法对15例重症手足口病患儿的临床标本进行EV71检测,RT-PCR扩增VP1基因目的片段测序,确定基因型.回顾性分析15例患儿的临床资料.结果 15例重症病例EV71核酸阳性,测序系C4型.全部病例均有体温异常,早期有不同程度神经系统受累.起病至出现重症合并症平均时间为1.26d.11例发展为神经源性肺水肿.4例予经鼻持续气道正压通气,11例气管插管呼吸机辅助通气.3例死亡,1例放弃,11例治愈.结论重症EV71感染起病初期就有不同程度神经系统受累,多数发展为神经源性肺水肿,EV71基因型为C4型.早期识别、及早呼吸支持可降低病死率.
목적 탐토장도병독71형(enterovirus 71,EV71)감염중증수족구병환인적림상특정급병원적기인형.방법 채용형광정량PCR방법대15례중증수족구병환인적림상표본진행EV71검측,RT-PCR확증VP1기인목적편단측서,학정기인형.회고성분석15례환인적림상자료.결과 15례중증병례EV71핵산양성,측서계C4형.전부병례균유체온이상,조기유불동정도신경계통수루.기병지출현중증합병증평균시간위1.26d.11례발전위신경원성폐수종.4례여경비지속기도정압통기,11례기관삽관호흡궤보조통기.3례사망,1례방기,11례치유.결론 중증EV71감염기병초기취유불동정도신경계통수루,다수발전위신경원성폐수종,EV71기인형위C4형.조기식별、급조호흡지지가강저병사솔.
Objective To explore the clinical feature of severe enterovirus 71 (EV71) associated hand foot and mouth disease (HFMD),and genotype of EV71.Methods Fluorescent quantitation PCR was done for detecting EV71.RT-PCR was performed to amplify VP1 for sequencing and identifying genotype.A retrospective analysis was performed based on the clinical data of 15 cases with severe EV71 infection.Results EV71 nucleotide was positive in all 15 cases.The genotype of EV71 was C4.All cases had abnormal temperature and followed with nervous symptoms in the early stage.Average time was 1.26 days from onset to severe complications appearance.Eleven cases progressed to neurogenic pulmonary edema.Four cases accepted nasal continuous positive airway pressure.Eleven cases accepted oral trachea cannula mechanical ventilation.Except for 3 cases died,one case abandoned,others 11 cases were cured.Conclusion The isolated strains of EV71 in this study are all C4 genotype.All cases with severe EV71 infection were followed with nervous symptoms in the early stage,most of whom would progress to neurogenic pulmonary edema.The mortality would be cut down by using mechanical ventilation in early stage.