CAJ | 학술논문

目的探讨手足口病患者不同样本病毒检出率差异，为手足口病检测样本的选择和疫情控制提供一定依据。方法用实时荧光定量PCR技术，通过一步法RT-PCR扩增对55例临床确诊为手足口病住院患儿的咽拭、肛拭、血液和尿液样本进行肠道病毒71型（EV71）和柯萨奇病毒A16型（CoxA16） PCR-荧光探针核酸检测。结果本组患者咽拭样本阳性37例（67.3%），肛拭样本阳性34例（61.8%），差异无统计学意义（χ2=0.8，P＞0.05）；血液样本阳性13例（23.6%），尿液样本阳性9例（16.4%），差异无统计学意义（χ2=2.25，P＞0.05）；血液、尿液样本阳性率同咽拭样本比较，差异均具有统计学意义（χ2分别为22.0和26.0，P均＜0.005）；肛拭、咽拭均阳性的33例样本中有9例肛拭样本的循环阈值（CT）小于咽拭，占24.2%（9/33）。结论为获得病原学依据，应对咽拭阴性的患者可进行肛拭样本检测。在疫情防控中，对手足口病患儿血液、尿液可能造成的感染应引起重视。
목적탐토수족구병환자불동양본병독검출솔차이，위수족구병검측양본적선택화역정공제제공일정의거。방법용실시형광정량PCR기술，통과일보법RT-PCR확증대55례림상학진위수족구병주원환인적인식、항식、혈액화뇨액양본진행장도병독71형（EV71）화가살기병독A16형（CoxA16） PCR-형광탐침핵산검측。결과본조환자인식양본양성37례（67.3%），항식양본양성34례（61.8%），차이무통계학의의（χ2=0.8，P＞0.05）；혈액양본양성13례（23.6%），뇨액양본양성9례（16.4%），차이무통계학의의（χ2=2.25，P＞0.05）；혈액、뇨액양본양성솔동인식양본비교，차이균구유통계학의의（χ2분별위22.0화26.0，P균＜0.005）；항식、인식균양성적33례양본중유9례항식양본적순배역치（CT）소우인식，점24.2%（9/33）。결론위획득병원학의거，응대인식음성적환자가진행항식양본검측。재역정방공중，대수족구병환인혈액、뇨액가능조성적감염응인기중시。
Objective To investigate the difference of detection rates among different samples which could provide scientiifc evidence for sample selection and epidemic situation handling. Methods Nucleic acids of enterovirus type 71 (EV71) and coxakie virus type A16 (CoxA16) from the specimens including blood, urine, throat and anal swab selected from 55 children diagnosed with HFMD, were ampliifed and detected by one step lfuorescent quantitative reverse transcription-PCR. Results Pharyngeal specimens were positive in 37 cases (67.3%) and anal specimens were positive in 34 cases (61.8%), with no signiifcant difference (χ2=0.8, P>0.05). Blood samples were positive in 13 cases (23.6%) and urine samples were positive in 9 cases (16.4%), with no significant difference (χ2=2.25, P>0.05). Compared with pharyngeal specimens the differences of positive detection in blood and urine specimens were both signiifcant (χ2 were 22.0 and 26.0, respectively;P<0.005). Among the 33 cases , with positive detection in both throat and anal swab specimens, 9 cases presented smaller cycle threshold (CT) in anal swab than throat specimens (24.2%). Conclusions Anal swab specimens should be selected in order to get the desired results when the detection of throat swab specimens show negative. Possible infections in blood or urine specimens should be taken seriously for epidemic prevention.