中国小儿急救医学
中國小兒急救醫學
중국소인급구의학
CHINESE PEDIATRIC EMERGENCY MEDICINE
2011年
6期
521-524
,共4页
李小青%闫晓莉%史艳萍%段明玥%刘小权
李小青%閆曉莉%史豔萍%段明玥%劉小權
리소청%염효리%사염평%단명모%류소권
危重手足口病%肠道病霉71型%临床特征
危重手足口病%腸道病黴71型%臨床特徵
위중수족구병%장도병매71형%림상특정
Severe hand,foot and mouth disease%Enterovirus 71%Clinical characteristics
目的 分析2010年陕西省危重型手足口病(hand,foot,and mouth disease,HFMD)患儿病原学及临床特点.方法 回顾性分析2010年3月至9月我院收治的26例危重型HFMD患儿的临床资料.采用反转录实时定量PCR方法检测其中20例危重患儿的咽拭子肠道病毒71型(enterovirus 71,EV71)及柯萨奇病毒A组16型的核酸,选择6个不同地区EV71阳性标本进行VP1全长基因扩增、测序,与国内其他地区毒株进行比较.结果 20例受检患儿中,EV71感染18例,2例为阴性.发病地区:渭南20例(76.9％),成阳地区4例,西安市区2例.6株EV71 VP1基因全长序列与安徽阜阳、我国香港、广州、深圳、山东、北京比较,同源性达96％～100％.危重型HFMD多发生于3岁以下患儿,男性多于女性,所有患儿伴持续高热、精神差、易惊、嗜睡、肢体抖动,外周血白细胞、C反应蛋白及血糖均明显升高,肾损伤少见.临床痊愈出院18例,其中遗留有肢体活动障碍2例,死亡8例.结论 陕西危重型HFMD以渭南地区高发,且以EV71感染为主,与我国其他地区EV71有高度同源性.危重型手足口病病情凶险,早期识别、早期干预可缓解病情,是降低病死率的关键.
目的 分析2010年陝西省危重型手足口病(hand,foot,and mouth disease,HFMD)患兒病原學及臨床特點.方法 迴顧性分析2010年3月至9月我院收治的26例危重型HFMD患兒的臨床資料.採用反轉錄實時定量PCR方法檢測其中20例危重患兒的嚥拭子腸道病毒71型(enterovirus 71,EV71)及柯薩奇病毒A組16型的覈痠,選擇6箇不同地區EV71暘性標本進行VP1全長基因擴增、測序,與國內其他地區毒株進行比較.結果 20例受檢患兒中,EV71感染18例,2例為陰性.髮病地區:渭南20例(76.9％),成暘地區4例,西安市區2例.6株EV71 VP1基因全長序列與安徽阜暘、我國香港、廣州、深圳、山東、北京比較,同源性達96％～100％.危重型HFMD多髮生于3歲以下患兒,男性多于女性,所有患兒伴持續高熱、精神差、易驚、嗜睡、肢體抖動,外週血白細胞、C反應蛋白及血糖均明顯升高,腎損傷少見.臨床痊愈齣院18例,其中遺留有肢體活動障礙2例,死亡8例.結論 陝西危重型HFMD以渭南地區高髮,且以EV71感染為主,與我國其他地區EV71有高度同源性.危重型手足口病病情兇險,早期識彆、早期榦預可緩解病情,是降低病死率的關鍵.
목적 분석2010년합서성위중형수족구병(hand,foot,and mouth disease,HFMD)환인병원학급림상특점.방법 회고성분석2010년3월지9월아원수치적26례위중형HFMD환인적림상자료.채용반전록실시정량PCR방법검측기중20례위중환인적인식자장도병독71형(enterovirus 71,EV71)급가살기병독A조16형적핵산,선택6개불동지구EV71양성표본진행VP1전장기인확증、측서,여국내기타지구독주진행비교.결과 20례수검환인중,EV71감염18례,2례위음성.발병지구:위남20례(76.9％),성양지구4례,서안시구2례.6주EV71 VP1기인전장서렬여안휘부양、아국향항、엄주、심수、산동、북경비교,동원성체96％～100％.위중형HFMD다발생우3세이하환인,남성다우녀성,소유환인반지속고열、정신차、역량、기수、지체두동,외주혈백세포、C반응단백급혈당균명현승고,신손상소견.림상전유출원18례,기중유류유지체활동장애2례,사망8례.결론 협서위중형HFMD이위남지구고발,차이EV71감염위주,여아국기타지구EV71유고도동원성.위중형수족구병병정흉험,조기식별、조기간예가완해병정,시강저병사솔적관건.
Objective To analyse the etiology and clinical characteristics of 26 critically ill children with severe hand foot and mouth disease (HFMD) of Shanxi province in 2010.Methods We retrospectively analysed the clinical data of 26 children with severe HFMD from Mar to Sep 2010.Nucleic acid of enterovirus 71 ( EV71 ) and Coxsackie virus A 16 ( CoxA16) were detected in 20 out of 26 children with HFMD by reversed real time polymerase chain reaction (rRT-PCR),and the whole VP1 gene of EV71 deriving from 6 different areas of Shanxi province was amplified,sequenced,and compared with strains from other areas in china.Results EV71 nucleic acid were positive in 18 out of 20 children,while the other two were negative for EV71 and CoxAl6.Among all the critical cases,20 cases (76.9％) occurred in Weinan area,four in Xianyang area,and two in Xi'an urban area.Compared with those of Fuyang Anhui,Hong Kong China,Guangzhou,Shenzhen,Shandong,Beijing,the homology of the whole VP1 gene sequence from 6 strains of Shanxi area was 96％ ～ 100％.Most of the critical children were under 3-year-old,and the incidence rate of male children was higher than that of female children.All affected children had persisted fever,poor energy,hyperarousal,hypersomnia,and limb shaking.Meanwhile their peripheral blood leukocytes,C-reactive protein and blood glucose were markedly increased,but renal injuries were rare.Eighteen children clinically recovered on discharge,among which 2 cases had sequelae of limb activity obstacle,and 8 cases died.Conclusion Weinan is the area with the highest incidence rate of critical HFMD cases in Shanxi Province,and the major etiological organism is EV71,which is highly homologous to EV71 found in other regions of mainland China.As many cases are in dangerous condition,thus early identification and intervention could inhibit the disease progression,and play a key role in reducing the mortality.
