中华临床感染病杂志
中華臨床感染病雜誌
중화림상감염병잡지
CHINESE JOURNAL OF CLINICAL INFECTIOUS DISEASES
2014年
1期
60-63
,共4页
赵昕峰%吴亦栋%高扬%周蕾%赵仕勇%韦翊
趙昕峰%吳亦棟%高颺%週蕾%趙仕勇%韋翊
조흔봉%오역동%고양%주뢰%조사용%위익
手足口病%肠道病毒71型%柯萨奇病毒感染%脑脊髓液
手足口病%腸道病毒71型%柯薩奇病毒感染%腦脊髓液
수족구병%장도병독71형%가살기병독감염%뇌척수액
Hand,foot and mouth disease%Enterovirus 71%Coxsackievirus infections%Cerebrospinal fluid
目的 分析肠道病毒71型(EV71)感染手足口病重症患儿的脑脊液特点和临床特征.方法 对杭州市儿童医院2013年5至8月收治的经反转录聚合酶链反应(RT-PCR)检测EV71阳性的重症手足口病患儿(EV71感染组)114例进行脑脊液常规和生化检查,并与同期入院的其他肠道病毒感染的78例重症手足口病患儿(对照组)脑脊液检测结果作比较,结合临床表现进行分析.计数资料的比较采用x2检验,计量资料的比较采用Mann-Whitney U检验.结果 EV71感染组呕吐(35.1％)和肢体抖动(50.9％)的发生率高于其他肠道病毒组,差异均有统计学意义(x2=7.864和19.682,P＜0.05);EV71感染组中脑脊液有核细胞计数≥100×106/L的患儿肢体抖动的发生率高于脑脊液有核细胞计数＜ 100×106/L的患儿(72.3％比35.8％,x2=14.740,P=0.000);EV71感染组脑脊液有核细胞计数和蛋白质定量及阳性率明显高于其他肠道病毒感染组(Z=-9.458和-6.591,P=0.000;x2=105.421和10.932,P=0.000和0.001).结论 EV71感染重症手足口病患儿神经系统损伤的临床症状及脑脊液检测的异常值较其他肠道病毒感染的重症患儿严重,且EV71感染组脑脊液有核细胞计数越高,肢体抖动越明显.
目的 分析腸道病毒71型(EV71)感染手足口病重癥患兒的腦脊液特點和臨床特徵.方法 對杭州市兒童醫院2013年5至8月收治的經反轉錄聚閤酶鏈反應(RT-PCR)檢測EV71暘性的重癥手足口病患兒(EV71感染組)114例進行腦脊液常規和生化檢查,併與同期入院的其他腸道病毒感染的78例重癥手足口病患兒(對照組)腦脊液檢測結果作比較,結閤臨床錶現進行分析.計數資料的比較採用x2檢驗,計量資料的比較採用Mann-Whitney U檢驗.結果 EV71感染組嘔吐(35.1％)和肢體抖動(50.9％)的髮生率高于其他腸道病毒組,差異均有統計學意義(x2=7.864和19.682,P＜0.05);EV71感染組中腦脊液有覈細胞計數≥100×106/L的患兒肢體抖動的髮生率高于腦脊液有覈細胞計數＜ 100×106/L的患兒(72.3％比35.8％,x2=14.740,P=0.000);EV71感染組腦脊液有覈細胞計數和蛋白質定量及暘性率明顯高于其他腸道病毒感染組(Z=-9.458和-6.591,P=0.000;x2=105.421和10.932,P=0.000和0.001).結論 EV71感染重癥手足口病患兒神經繫統損傷的臨床癥狀及腦脊液檢測的異常值較其他腸道病毒感染的重癥患兒嚴重,且EV71感染組腦脊液有覈細胞計數越高,肢體抖動越明顯.
목적 분석장도병독71형(EV71)감염수족구병중증환인적뇌척액특점화림상특정.방법 대항주시인동의원2013년5지8월수치적경반전록취합매련반응(RT-PCR)검측EV71양성적중증수족구병환인(EV71감염조)114례진행뇌척액상규화생화검사,병여동기입원적기타장도병독감염적78례중증수족구병환인(대조조)뇌척액검측결과작비교,결합림상표현진행분석.계수자료적비교채용x2검험,계량자료적비교채용Mann-Whitney U검험.결과 EV71감염조구토(35.1％)화지체두동(50.9％)적발생솔고우기타장도병독조,차이균유통계학의의(x2=7.864화19.682,P＜0.05);EV71감염조중뇌척액유핵세포계수≥100×106/L적환인지체두동적발생솔고우뇌척액유핵세포계수＜ 100×106/L적환인(72.3％비35.8％,x2=14.740,P=0.000);EV71감염조뇌척액유핵세포계수화단백질정량급양성솔명현고우기타장도병독감염조(Z=-9.458화-6.591,P=0.000;x2=105.421화10.932,P=0.000화0.001).결론 EV71감염중증수족구병환인신경계통손상적림상증상급뇌척액검측적이상치교기타장도병독감염적중증환인엄중,차EV71감염조뇌척액유핵세포계수월고,지체두동월명현.
Objective To investigate cerebrospinal fluid characteristics and clinical features in children with severe hand,foot and mouth disease (HFMD) induced by enterovirus 71 (EV71) infection.Methods A total of 114 children with severe HFMD,in whom EV71 was detected by reverse transcription polymerase chain reaction (RT-PCR),were admitted in Hangzhou Children's Hospital during May and August 2013.Seventy-eight children with severe HFMD induced by other enteroviruses admitted at the same period served as controls.The results of cerebrospinal fluids (CSF) routine examination and biochemical tests,and the clinical symptoms were compared between two groups.Differences in enumeration data were compared with x2 test,and measurement data were compared with Mann-Whitney U test.Results The incidences of vomiting and limb shaking in EV71 infection group were 35.1％ and 50.9％,which were higher than those in control group (x2 =7.864 and 19.682,P ＜ 0.05).The incidence of limb shaking in children with nucleated cells count ≥ 100 × 106/L in EV71 group was higher than that with nucleated cells count ＜ 100 × 106/L (72.3％ vs.35.8％,x2 =14.740,P =0.000).The nucleated cells count,protein quantity and their positive rates in EVT1 infected group were higher than those in control group (Z =-9.458 and-6.591,P=0.000; x2=105.421 and 10.932,P =0.000 and 0.001).Conclusion The symptoms of nervous system damage and abnormal CSF examination were more serious in HFMD induced by EV71 infection,and in EV71 infected patients the incidence of limb shaking is correlated with nucleated cell count in CSF.
