海南医学
海南醫學
해남의학
HAINAN MEDICAL JOURNAL
2014年
20期
3097-3100
,共4页
手足口病%聚集性%重型%病原学
手足口病%聚集性%重型%病原學
수족구병%취집성%중형%병원학
Hand,foot and mouth disease%Clustering%Severe%Etiology
目的：通过对手足口病聚集性病例和重症病例进行病原学检测，发现该地区手足口病原体的类型，为手足口病防控提供病原学依据。方法通过临床医生和流调人员采集符合聚集性疫情的手足口病病例和诊断为重症病例的咽拭子标本，应用RT-PCR方法检测原始样本和分离阳性病毒株中EV、EV71和CoxA16病毒的核酸。结果聚集性疫情病例咽拭子标本共276例，共分离出病毒125例，阳性率为45.29%；其中EV71阳性率为17.75%(49/276)，CoxA16阳性率为26.09%(72/276)，其他EV阳性率为1.45%(4/276)。重症病例咽式子标本共21例，共分离出病毒8例，阳性率为38.09%；其中EV71阳性率为9.52%(2/21)，CoxA16阳性率为23.81%(5/21)，其他EV阳性率为4.76%(1/21)。聚集性疫情病例中散居儿童、学生中CoxA16的检出率高于托幼儿童，其差异有统计学意义(χ2=3.843，P=0.050和χ2=8.048，P=0.005)。结论顺义区手足口病聚集性疫情病例和重症病例均以CoxA16病毒感染为主。聚集性疫情病例以托幼儿童为主，重症病例以散居儿童为主。应加强手足口病的病原学监测，为落实防控措施及明确临床诊断提供实验室依据。
目的：通過對手足口病聚集性病例和重癥病例進行病原學檢測，髮現該地區手足口病原體的類型，為手足口病防控提供病原學依據。方法通過臨床醫生和流調人員採集符閤聚集性疫情的手足口病病例和診斷為重癥病例的嚥拭子標本，應用RT-PCR方法檢測原始樣本和分離暘性病毒株中EV、EV71和CoxA16病毒的覈痠。結果聚集性疫情病例嚥拭子標本共276例，共分離齣病毒125例，暘性率為45.29%；其中EV71暘性率為17.75%(49/276)，CoxA16暘性率為26.09%(72/276)，其他EV暘性率為1.45%(4/276)。重癥病例嚥式子標本共21例，共分離齣病毒8例，暘性率為38.09%；其中EV71暘性率為9.52%(2/21)，CoxA16暘性率為23.81%(5/21)，其他EV暘性率為4.76%(1/21)。聚集性疫情病例中散居兒童、學生中CoxA16的檢齣率高于託幼兒童，其差異有統計學意義(χ2=3.843，P=0.050和χ2=8.048，P=0.005)。結論順義區手足口病聚集性疫情病例和重癥病例均以CoxA16病毒感染為主。聚集性疫情病例以託幼兒童為主，重癥病例以散居兒童為主。應加彊手足口病的病原學鑑測，為落實防控措施及明確臨床診斷提供實驗室依據。
목적：통과대수족구병취집성병례화중증병례진행병원학검측，발현해지구수족구병원체적류형，위수족구병방공제공병원학의거。방법통과림상의생화류조인원채집부합취집성역정적수족구병병례화진단위중증병례적인식자표본，응용RT-PCR방법검측원시양본화분리양성병독주중EV、EV71화CoxA16병독적핵산。결과취집성역정병례인식자표본공276례，공분리출병독125례，양성솔위45.29%；기중EV71양성솔위17.75%(49/276)，CoxA16양성솔위26.09%(72/276)，기타EV양성솔위1.45%(4/276)。중증병례인식자표본공21례，공분리출병독8례，양성솔위38.09%；기중EV71양성솔위9.52%(2/21)，CoxA16양성솔위23.81%(5/21)，기타EV양성솔위4.76%(1/21)。취집성역정병례중산거인동、학생중CoxA16적검출솔고우탁유인동，기차이유통계학의의(χ2=3.843，P=0.050화χ2=8.048，P=0.005)。결론순의구수족구병취집성역정병례화중증병례균이CoxA16병독감염위주。취집성역정병례이탁유인동위주，중증병례이산거인동위주。응가강수족구병적병원학감측，위락실방공조시급명학림상진단제공실험실의거。
Objective To understand the type and distribution of the pathogen according to pathogen detec-tion of clustering and severe case of hand, foot and mouth disease (HFMD), and to provide scientific evidence for HFMD prevention and control. Methods Throat swab of clinically diagnosed cases with clustering and severe case of HFMD were collected by clinical and epidemiological investigation doctor. Nucleic acid of three types of virus, en-tervirus (EV), entervirus 71 (EV71) and Coxasckievirus A16 (CoxA16) was detected by RT-PCR both in original sam-ples and isolated positive virus strains. Results Of the 276 diagnosed clustering cases, 125 cases (45.29%) were test-ed positive, including 49 cases (17.75%) of EV71 positive, 72 cases (26.09%) of CoxA16 positive, and 4 cases (1.45%) of EV positive. Of 21 diagnosed severe cases, 8 cases (38.09%) were tested positive, including 2 cases (9.52%) of EV71 positive, 5 cases (23.81%) of CoxA16 positive, and 1 case (4.76%) of EV positive. The positive rate of CoxA16 were significantly higher in scattered children and students than kindergartens children (χ2=3.843, P=0.050 andχ2=8.048, P=0.005). Conclusion The clustering and severe cases of HFMD are mainly caused by CoxA16 in Shunyi District of Beijing. The clustering cases of HFMD are mainly from kindergartens children, and the severe cas-es of HFMD mainly come from students. The pathogen detection of HFMD should be carried out in hospital, to pro-vide etiology basis for clinical diagnoses of HFMD and for practicable prevention and control.
