2008-2013年国内报道的手足口病病原体构成的Meta分析

摘要

Objective To find out epidemic pattern and characteristics of the pathogens causing hand,foot and mouth disease (HFMD) by Meta-analysis on pathogen-testing results published in domestic literatures.Method Articles from 2008 to 2013 in CNKI database were retrieved and analyzed by Meta-analysis with Review Manager 5.0 software.Results Twenty-four articles with total 15 360 samples were collected.The combined odds ratio (OR) of samples positive for enterovirus 71 (EV71) and coxsackievirus A16 (CA16) detected by real time PCR was 2.10 with a 95％ confidence interval (CI) of 1.37-3.23.The infection risk of EV71 was slightly higher than that of CA16 (Z=3.40,P=0.0007).The combined OR (95 ％ CI) of samples positive for enterovirus (EV),EV71 and CA16 between different genders (male and female) were 1.19 (0.97-1.46),1.01 (0.81-1.26) and 1.36 (1.04-1.78),respectively.There was a significant difference of CA16 infection risk between males and females (Z=2.23,P=0.03).The combined OR (95％ CI) of samples positive for EV,EV71 and CA16 between two age groups,0-3 years old (excluding 3 years old) and 3-6 years old (excluding 6 years old) were 1.01 (0.69-1.48),0.88 (0.58-1.35) and 0.98 (0.65-1.47),respectively.Conclusions There is slight or no difference of infection risk between EV71,CA16 and other EV in general population as well as in different gender and age.Therefore,same measures should be taken to prevent HFMD regardless of pathogens,gender and age.%目的 利用Meta分析的方法对国内发表文献中的手足口病病原体检测结果进行分析,找出手足口病病原体在人群中传播的规律和特点,为手足口病的防治提供参考.方法 从CNKI中国知网中收集2008年至2013年发表的符合纳入标准的文献,用Review Manager 5.0软件对手足口病病原体的构成情况进行Meta分析.结果 共筛选到24篇符合标准的文献,总样本量为15 360份.主要病原体肠道病毒71型(enterovirus 71,EV71)和柯萨奇病毒A组16型(coxsackievirus A16,CA16)的实时荧光PCR检出数的合并比数比(odds ratio,OR)为2.10,95％可信区间(CI)为1.37～3.23,EV71的感染风险略高于CA16(Z=3.4(0,P=0.0007).不同性别(男、女)间总肠道病毒、EV71、CA16检出数的合并OR值(95％CI)分别为1.19(0.97～1.46)、1.01(0.81～1.26)和1.36(1.04～1.78),CA 16的感染风险在不同性别间的差异有统计学意义(Z=2.23,P=0.03).不同年龄段[0～3岁(不含3岁)、3～6岁(不含6岁)]总肠道病毒、EV71、CA16检出数的合并OR值(95％CI)分别为1.01(0.69～1.48)、0.88(0.58～1.35)和0.98(0.65～1.47),不同年龄段之间三者的感染风险差异均无统计学意义.结论 EV71、CA 16和其他肠道病毒在总体人群以及不同性别、不同年龄段之间的感染风险无差异或差异不大,因此,在预防手足口病过程中,对不同病原体、不同性别、不同年龄段都应等而视之.