CAJ | 학술논문

目的研究2008年深圳市轻型和重型手足口病临床特点和实验室特征.方法将深圳市东湖医院和儿童医院共145例手足口病住院患者作为研究对象,其中轻型124例,重型21例.收集患者临床和一般实验室资料,急性期与恢复期连续粪便和血标本,通过RT-PER检测EV71病毒核酸,分离和培养EV71肠道病毒,其中2例死亡患者行病理组织学检测.结果与轻型患者比较,重型患者白细胞计数、血糖显著升高,但年龄显著降低,粪便中轻型和重型患者EV71基因检出率分别为35%与67%,重型患者EV71检出率显著高于轻型患者,从9例患者粪便中分离培养出肠道病毒,其中1例为死亡患者粪便标本.2例患者死于神经源性肺水肿和脑干脑炎.结论 EV71是重型患者和死亡患者的最主要病原体,神经源性肺水肿和脑干脑炎是EV71型手足口病的最主要死亡原因,对年龄小于4岁,高热、皮疹稀疏和高血糖的EV71型手足口病患者应警惕向重型发展.
목적 연구2008년심수시경형화중형수족구병림상특점화실험실특정.방법 장심수시동호의원화인동의원공145례수족구병주원환자작위연구대상,기중경형124례,중형21례.수집환자림상화일반실험실자료,급성기여회복기련속분편화혈표본,통과RT-PER검측EV71병독핵산,분리화배양EV71장도병독,기중2례사망환자행병리조직학검측.결과 여경형환자비교,중형환자백세포계수、혈당현저승고,단년령현저강저,분편중경형화중형환자EV71기인검출솔분별위35%여67%,중형환자EV71검출솔현저고우경형환자,종9례환자분편중분리배양출장도병독,기중1례위사망환자분편표본.2례환자사우신경원성폐수종화뇌간뇌염.결론 EV71시중형환자화사망환자적최주요병원체,신경원성폐수종화뇌간뇌염시EV71형수족구병적최주요사망원인,대년령소우4세,고열、피진희소화고혈당적EV71형수족구병환자응경척향중형발전.
Objective To study the clinical and laboratory features of the mild and severe hand-foot-mouth diseases (HFMD) in Shenzhen in 2008.Methods 145 cases were observed in East-Lake Hospital and Shenzhen Children's Hospital. Of the 145 cases,124 mild eases and 21 severe cases were involved. All the clinical data and Laboratory findings were collected and summarized. After collection of the acute and convalescent consecutive stools and peripheral bloods from the patients with HFMD,EV71 genes were amplified from these samples by RT-PCR. Enterovirus 71 were cultured and isolated using Veto cell line and R&D cell line. Results The WBC counts and blood glucose levels of the severe cases were significantly elevated,but the ages of the severe ones significantly decreased compared with those of the mild cases( P < 0.05). EV71 genes could be detected by RT-PCR with 35% positive rate in mild cases and 67% in severe eases.The EV71 gene detection rate of the severe cases was significantly increased in contrast to that of the mild ones. The EV71 were isolated and cultured from the stools of 9 patients,one specimens from the dead's stool. Two severe cases died of neurngenic pulmonary edema and brain-stem encephalitis. Conclusions EV71 mainly contributes to HFMD and is responsible for death of some severe cases. High fever,less rash,elevated white blood cell counts and blood glucose concentrations as well as age less than 4 years old should be used for prediction of severe cases.