Objectives To investigate major pathogens and clinical characteristics of herpangina during outbreak of hand foot and mouth disease (HFMD). Methods The clinical data from 135 patients with herpangina during outbreak of HFMD were studied retrospectively. Enteraviruses 71 (EV71) and Coxsackie virus group A18 (CA18) were detected by real-time polymerase chain reaction. The laboratory data and clinical characteristics were analyzed and compared between children with EV71 and CAW detected. Results The results of pathogen detection showed 50 of 135 (37.04%) patients were EV71 positive, and 44 patients (32.59%) were CA16 positive. Between EV71 infected group and CA16 infected group, the incidence of diseases related to nervous system, respiratory system, circulatory system was significantly different (P<0.05). No significant difference was found in incidence of various clinical manifestations, including age <3 years old, persistent high fever, white blood ceil count, blood sugar, erythrocyte sedimentation rate, hypersensitive C-reactive protein, CK-MB, ALT, BUN, and etc, between the two groups (P>0.05). Two patients with EV71 infected died due to pulmonary hemorrhage. Conclusions Pathogen of herpangina might be same as pathogen of HFMD during the outbreak of HFMD and the management of herpangina should be included into the management of HFMD. However, the laboratory investigation indicating server case of HFMD cannot be used as specific indicators of early diagnosis of severe case of herpangina.%目的 探讨手足口病(HFMD)流行期疱疹性咽峡炎主要致病原及临床特点.方法回顾性分析HFMD 流行期间135 例疱疹性咽峡炎患儿的临床资料,采用real-time PCR 法检测肠道病毒71 型(EV71)及柯萨奇病毒A 组16 型(CA16),比较EV71 及CA16 感染患儿的临床特点、实验室指标等.结果 135 例疱疹性咽峡炎患儿病原检测显示EV71 阳性50 例,占37.04%(50/135),CA16 阳性44 例,占32.59%(44/135).EV71、CA16 感染患儿比较显示,神经系统、呼吸系统、循环系统重症表现的发生率,两组间差异有统计学意义(P<0.05);年龄<3 岁、高热持续不退、白细胞计数、血糖、血沉、高敏C 反应蛋白(Hs-CRP)、肌酸激酶同工酶(CK-MB)、丙氨酸转氨酶(ALT)、BUN 等异常的发生率,两组间差异无统计学意义(P>0.05).EV71 感染因肺出血死亡2 例.结论疱疹性咽峡炎的致病原可能与同期HFMD 流行致病原相平行,临床上应重视疱疹性咽峡炎,并应将其纳入HFMD 范畴进行管理,判定HFMD 重症病例的某些指标及实验室检查数据对疱疹性咽峡炎重症病例的早期识别无特异性临床指导意义.
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