CAJ | 학술논문

目的：了解湖州市2013~2014年手足口病病原构成及其临床相关特征。方法采集208例疑似手足口病感染者的253份标本(咽拭子45份和粪便208份)和相关临床资料，采用一步法三色荧光定量RT-PCR检测临床样本。结果一步法荧光定量RT-PCR检测表明，208例手足口病患儿中，EV的检出率为83.17%(173/208)，其中EV71、CoxA16和其他EV亚型所占EV的比例分别为55.49%、13.29%和31.21%，且男、女患儿之间的检测结果并无显著差异。5岁及以下(≤5岁)手足口病患儿中，主要的病原为EV71，而5岁以上以其他EV亚型为主；临床症状以发热伴疱疹为手足口病的主要症状，而引起发热伴呕吐、疱疹或神经系统症状的主要肠道病毒为EV71。此外粪便样本的EV检出率高于咽拭子样本的EV检出率。结论肠道病毒EV71和其他EV亚型是湖州市儿童手足口病的优势病原体，而CoxA16病毒呈现下降趋势，因此加强EV、EV71和CoxA16的监测有助于更好地预防和控制手足口病。
목적：료해호주시2013~2014년수족구병병원구성급기림상상관특정。방법채집208례의사수족구병감염자적253빈표본(인식자45빈화분편208빈)화상관림상자료，채용일보법삼색형광정량RT-PCR검측림상양본。결과일보법형광정량RT-PCR검측표명，208례수족구병환인중，EV적검출솔위83.17%(173/208)，기중EV71、CoxA16화기타EV아형소점EV적비례분별위55.49%、13.29%화31.21%，차남、녀환인지간적검측결과병무현저차이。5세급이하(≤5세)수족구병환인중，주요적병원위EV71，이5세이상이기타EV아형위주；림상증상이발열반포진위수족구병적주요증상，이인기발열반구토、포진혹신경계통증상적주요장도병독위EV71。차외분편양본적EV검출솔고우인식자양본적EV검출솔。결론장도병독EV71화기타EV아형시호주시인동수족구병적우세병원체，이CoxA16병독정현하강추세，인차가강EV、EV71화CoxA16적감측유조우경호지예방화공제수족구병。
Objective To explore the pathogens and clinical characterization of hand,foot and mouth disease (HFMD)in Huzhou city from 2013 to 2014. Methods All 253 specimens included 208 stool specimens and 45 throat swabs,and clinical data from 208 children cases with hand,foot and mouth diseases (HFMD)were collected. Preliminary de-tection for all of the specimens was performed by one-step triple real-time RT-PCR assay. Results Real-time RT-PCR assay indicated that the positive rate of Enterovirus(EV)from 208 cases was 83.17%(173/208),and the percent-ages of EV71,CoxA16 and other's EV subtypes in 173 enteroviruses were 55.49%,13.29%and 31.21%,respectively. These results were not significant differences between male and female children. EV71 from children with HFMD was predominant strain below 5 old years (≤5),and other's EV subtypes were predominant strains over 5 years (>5). Of fever with herpes was main clinical symptom in patients with HFMD,and EV71 was primary enterovirus induced many clinical features, such as fever with herpes or vomiting or neurological symptoms and so on. Additionally, detection rate of EV in stool specimens was significant higher than that in throat swabs. Conclusion EV71 and other's EV sub-types are predominant strains, CoxA16 strains have a downtrend in patients with HFMD in Huzhou city, so that the medical workers should improve the ability of surveillance to EV,EV71 and CoxA16 in order to make better for control and prevention of the HFMD diseases.