CAJ | 학술논문

目的了解2009年徐州地区肠道病毒感染引起手足口病情况,为手足口病防控工作提供科学依据.方法采用荧光RT-PCR方法对240例临床诊断为肠道病毒感染的手足口病例中的222例肛拭子和咽拭子标本同时进行EV和EV71、CA16特异性RNA检测,用ELA方法对其中的114例急性期血清标本进行EV71-IgM抗体检测.同时检测健康儿童254份咽拭子和258份血清标本以及密切接触者咽拭子54份标本.结果 240例疑似肠道病毒感染者,总EV感染率为72.50%(174/240),其中EV71感染率为57.92%(139/240),CoxA16感染率为9.17%(22/240),其他EV感染率为5.42%(13/240).240例疑似肠道病毒感染者中的222份肛拭子标本EV71-RNA阳性率为45.94%(102/222)、咽拭子EV71-RNA阳性率为25.68%(57/222),114份急性期血清中EV71-IgM抗体阳性率为86.84%(99/114).254份健康儿童咽拭子EV71-RNA阳性率为1.57%(4/254),未检出CoxA16-RNA;258份健康儿童血清标本EV71-IgM抗体阳性率是2.71%(7/258).密接(医护人员)咽拭子54份,EV-RNA检测均为阴性.结论徐州地区手足口病流行主要由EV71型引起.3岁以下儿童流行期间存在被EV71型隐性感染,并产生IgM抗体.成人即使密切接触传染源也不易被感染EV71.疑似病例急性期血清中EV71-IgM抗体检测阳性率最高(86.84%),其次为肛拭子EV71(45.94%)和咽拭子EV71(25.68%)的RNA检测阳性率.ELA试剂盒用于EV71型感染的早期诊断,具有操作简单快速经济,值得在基层推广.
목적 료해2009년서주지구장도병독감염인기수족구병정황,위수족구병방공공작제공과학의거.방법 채용형광RT-PCR방법대240례림상진단위장도병독감염적수족구병례중적222례항식자화인식자표본동시진행EV화EV71、CA16특이성RNA검측,용ELA방법대기중적114례급성기혈청표본진행EV71-IgM항체검측.동시검측건강인동254빈인식자화258빈혈청표본이급밀절접촉자인식자54빈표본.결과 240례의사장도병독감염자,총EV감염솔위72.50%(174/240),기중EV71감염솔위57.92%(139/240),CoxA16감염솔위9.17%(22/240),기타EV감염솔위5.42%(13/240).240례의사장도병독감염자중적222빈항식자표본EV71-RNA양성솔위45.94%(102/222)、인식자EV71-RNA양성솔위25.68%(57/222),114빈급성기혈청중EV71-IgM항체양성솔위86.84%(99/114).254빈건강인동인식자EV71-RNA양성솔위1.57%(4/254),미검출CoxA16-RNA;258빈건강인동혈청표본EV71-IgM항체양성솔시2.71%(7/258).밀접(의호인원)인식자54빈,EV-RNA검측균위음성.결론 서주지구수족구병류행주요유EV71형인기.3세이하인동류행기간존재피EV71형은성감염,병산생IgM항체.성인즉사밀절접촉전염원야불역피감염EV71.의사병례급성기혈청중EV71-IgM항체검측양성솔최고(86.84%),기차위항식자EV71(45.94%)화인식자EV71(25.68%)적RNA검측양성솔.ELA시제합용우EV71형감염적조기진단,구유조작간단쾌속경제,치득재기층추엄.
Objective To understand and master the situation in which enteroviros caused handfoot-and-mouth disease(HFMD) in Xuzhou district in 2009 so as to provide scientific basis for the control and prevention of hand-foot-and-mouth disease. Methods The researchers adopted fluorescence RT-PCR method to detect EV and EV71 as well as the CAI6 specificity RNA from 222 samples of anal swabs and oropharyngeal swabs from the 240 cases who were diagnosed clinically as hand-foot-mouth disease infected by enterovirus. Also, the researchers conducted EV71-IgM antibody detection on 114 samples of acute phase serum with ELA method. Results Among the 240 enterovirus infected patients, the total EV infection rate is 72.50% ( 174/240), among which EV71 infection rate is 57. 92% ( 139/240), CoxA16 infection rate is 9. 17% (22/240), and other EV infection rate is 5.42% (13/240). The EV71-RNA positive rate of the samples of 222 anus swabs among the 240 suspected enterovirus infected patients is 45.94% ( 102/222 ),the samples of swallow swab EV71-RNA positive rate is 25.68% (57/222) and the EV71-IgM antibody positive rate of 114 samples of acute phase serum is 86. 84% (99/114). The EV71-RNA positive rate of oropharyngeal swabs of 254 healthy children is 1.57% (4/254), and no CoxA16-RNA was detected. In the oropharyngeal swabs of 54 close contacts (medical personnel), the EV-RNA detected is negative. The positive rate of EV71-lgM antibody of the 258 healthy children's serum samples is 2.71% (7/258).Conclusion The widespreading of hand-foot-mouth disease in Xuzhou district is caused mainly by type 71 enterovirus. Inapparent infection of type 71 enterovirus exists among children under the age of 3 during the time of widespreading period and IgM antibody develops in them. It is difficult for adults to be infected by EV71 even if they contact the contagion source closely. The positive rate of EV71-IgM antibody in the samples of acute phase serum of suspected cases is the highest ( 86.84% ), and the second highest is the positive rate of RNA of EV71 of anal swabs (45.94%) and of the EV71 of oropharyngeal swabs (25.68%). ELA reagent kit is used in the early diagnosis of EV71 infection for it is easy to operate, fast and economic, so, it is worth popularizing in the grass-root medical units.