CAJ | 학술논문

目的：掌握2012年度北京大学北京地坛医院教学医院手足口病住院患儿的病原体分布情况与变化趋势，为手足口病的防治提供科学依据。方法本研究收集北京大学北京地坛医院教学医院儿科2012年度211例手足口病住院患儿的咽拭子标本，提取病毒RNA，采用实时荧光聚合酶链反应（RT-PCR）法，进行肠道病毒（EV）通用型、肠道病毒71（EV71）型和柯萨奇A16（CoxA16）型肠道病毒核酸检测。EV（+）标本判为EV阳性，EV（+）EV71（+）标本判为EV71阳性，EV （+）CoxA16（+）标本判为CoxA16阳性，EV（+）且EV71（-）CoxA16（-）标本判为非EV71非CoxA16型肠道病毒阳性。结果2012年度211例本院手足口病住院患儿中EV阳性标本共118例，占55.92%。病毒分型结果显示，非EV71非CoxA16型肠道病毒阳性标本共46例，占22.81%；EV71阳性标本共45例，占21.32%；CoxA16阳性标本共27例，占12.80%。病原学分布分析结果显示，5～7月份为发病高峰期；不同年龄、性别组患儿之间病原体构成无显著差异；患儿入院前3d肠道病毒检出率较3 d后高；不同型别肠道病毒感染患儿之间平均住院天数差异无统计学意义。结论2012年度本院手足口病住院患儿不同型别EV感染率由高到低依次为：非EV71非CoxA16型肠道病毒、EV71、CoxA16，非EV71非CoxA16型肠道病毒感染率较往年具有升高趋势，尚待进一步研究。
목적：장악2012년도북경대학북경지단의원교학의원수족구병주원환인적병원체분포정황여변화추세，위수족구병적방치제공과학의거。방법본연구수집북경대학북경지단의원교학의원인과2012년도211례수족구병주원환인적인식자표본，제취병독RNA，채용실시형광취합매련반응（RT-PCR）법，진행장도병독（EV）통용형、장도병독71（EV71）형화가살기A16（CoxA16）형장도병독핵산검측。EV（+）표본판위EV양성，EV（+）EV71（+）표본판위EV71양성，EV （+）CoxA16（+）표본판위CoxA16양성，EV（+）차EV71（-）CoxA16（-）표본판위비EV71비CoxA16형장도병독양성。결과2012년도211례본원수족구병주원환인중EV양성표본공118례，점55.92%。병독분형결과현시，비EV71비CoxA16형장도병독양성표본공46례，점22.81%；EV71양성표본공45례，점21.32%；CoxA16양성표본공27례，점12.80%。병원학분포분석결과현시，5～7월빈위발병고봉기；불동년령、성별조환인지간병원체구성무현저차이；환인입원전3d장도병독검출솔교3 d후고；불동형별장도병독감염환인지간평균주원천수차이무통계학의의。결론2012년도본원수족구병주원환인불동형별EV감염솔유고도저의차위：비EV71비CoxA16형장도병독、EV71、CoxA16，비EV71비CoxA16형장도병독감염솔교왕년구유승고추세，상대진일보연구。
Objective To investigate the distribution and variation of pathogens among pediatric patients with hand, foot and mouth diseases (HFMD) in Beijing Ditan Hospital, Peking University Teaching Hospital, in 2012, and to provide scientific basis for the prevention and treatment of HFMD. Methods Throat swabs of 211 cases hospitalized in Division of Pediatrics, Beijing Ditan Hospital, Peking University Teaching Hospital, in 2012 were collected. Real-time lfuorescence quantitative (RT-PCR) kits with universal enterovirus (EV) primers, Coxsackievirus A16 (CoxA16)-speciifc primers and enterovirus 71 (EV71)-speciifc primers were used to detect the samples after RNA extraction. The samples were identiifed as EV-positive, EV71-positive, CoxA16-positive, if they could be detected with EV primers, EV primers and EV71-speciifc primers, EV primers and CoxA16-speciifc primers, correspondingly. Non-EV71, non-CoxA16 enteroviruses referred to those which could be detected by EV primers, but not by EV71-specific primers or CoxA16-speciifc primers. Results There were 118 enterovirus positive cases among the 211 patients, accounting for 55.92%. Among them, the positive rates of non-EV71, non-CoxA16 enteroviruses, EV71 and CoxA16 were 22.81%(46/211), 21.32%(45/211) and 12.80%(27/211), respectively. The peak incidence time of HFMD was from May to July. There were no signiifcant differences between patients grouped by ages or genders in pathogen distribution. The detection positive rate of specimens collected within 3 days after admission was higher than 3 days later. There were no signiifcant differences in the number of hospitalisation days between patients infected by different EVs. Conclusions In 2012, the positive rate of non-EV71 non-CoxA16 enteroviruses was higher than EV71, which was higher than CoxA16 in our study. There was an increasing trend of the positive rate of non-EV71 non-CoxA16 enteroviruses, which deserve future study.