肠道病毒71型重症手足口病患儿病毒载量及并发症的分析

摘要

目的 分析肠道病毒71型(EV71)重症手足口病(HFMD)患儿病毒载量及并发症的分析.方法 回顾性分析2013年1月至2016年12月收治的EV71重症HFMD患儿320例的临床资料,采用荧光定量聚合酶链反应(Q-PCR)检测EV71重症HFMD患儿病毒载量,分析其与并发症的关系.结果 EV71危重型HFMD患儿的病毒载量显著高于EV71重型HFMD患儿,差异有统计学意义(P<0.05).与EV71重型HFMD患儿比较,EV71危重型HFMD患儿神经系统损害、呼吸衰竭、循环衰竭及心肌损害的发生率显著升高,差异有统计学意义(P<0.05).与无菌性脑膜炎患儿相比,脑干脑炎、急性迟缓性麻痹患儿EV71病毒载量明显增加,且急性迟缓性麻痹患儿EV71病毒载量明显高于脑干脑炎患儿,差异有统计学意义(P<0.05).结论 EV71重症HFMD患儿病毒载量与病情、并发症严重程度相关,病毒载量的检测有助于病情监测、指导临床诊疗.%Objective To analyze the viral load and complications in children patients with severe hand-foot-mouth disease(HFMD) caused by enterovirus type 71(EV71) .Methods The clinical data in 320 children patients with severe HFMD caused by EV71 treated in this hospital from January 2013 to December 2016 were retrospectively analyzed .The viral load in children patients with severe EV 71 caused HFMD was detected by adopting the fluorescence quantitative polymerase chain reaction (Q-PCR) ,and its correlation with the compli-cations was analyzed .Results The viral load in the children patients with critical type HFMD was significant-ly higher than that in the children patient with severe type HFMD ,the difference was statistically significant (P<0 .05) .Compared with severe HFMD ,the incidence rate of nervous system damage ,respiratory failure , circulatory failure and myocardial damage in critical type HFMD were significantly increased ,the difference was statistically significant (P<0 .05) .Compared with the EV71 viral load in the children patients with asep-tic meningitis ,the EV71 viral load in the children patients with brainstem encephalitis and acute flaccid paraly-sis were increased significantly ,moreover the EV71 viral load in the children patients with acute flaccid paraly-sis was significantly higher than that in the children patients with brainstem encephalitis ,the difference was statistically significant (P<0 .05) .Conclusion The viral load in children patients with severe HFMD caused by EV71 is correlated with severity of disease condition and complications ,and the viral load detection is con-ducive to disease condition monitoring and guidance of clinical treatment .