洛阳市2009~2013年手足口病病原学分析

摘要

目的：通过对洛阳市2009~2013年手足口病（HFMD）病原学进行分析，为该地区HFMD的防治提供一定理论依据。方法按照洛阳市手足口病防控要求，每月要求洛阳市辖内9县6区定点医院采集一定量HFMD患儿粪便标本，采用实时定量聚合酶链反应（RT-PCR）法检测人肠道病毒71型（EV71）、柯萨奇病毒A组16型（CA16）及其他类型病原类型并进行分析。结果洛阳市2009~2013年共检测标本4225例，实验室确诊3248例，阳性率为76.88%；洛阳市引发HFMD病原主要是EV71，但其降低趋势明显，而CA16和其他肠道病毒引起HFMD所占比例逐年稳步升高；2010年HFMD病原性别分布比较，差异有统计学意义（χ2=9.48，P=0.009）；其他年度HFMD病原性别分布比较，差异均无统计学意义（P>0.05）。除2013年外，HFMD病原的城乡分布比较，差异均有统计学意义（χ2=9.48，P=0.009）。结论洛阳市2009~2013年HFMD病原构成存在一定变化趋势且城乡分布存在显著差异，应及时对HFMD病原进行检测，并分析流行原因，以便更好地对HFMD进行防治。%Objective To provide a certain theoretical basis for hand-foot-mouth disease ( HFMD ) prevention by pathogenic analysis of HFMD in Luoyang city in 2009-2013. Methods According to the requirements of HFMD prevention of Luoyang,stool samples of HFMD children were collected in 9 counties and 6 districts of Luoyang every month. By real-time-quan-titative polymerase chain reaction(RT-PCR) method,the human enterovirus type 71(EV71),coxsackievirus group A type 16(CA16) and pathogenic types of other virus were detected and analyzed. Results In 2009-2013,a total of 4 225 samples were examined in Luoyang city,3 248 were laboratory-confirmed with the positive ratio of 76.88%. EV71,the main pathogen of HFMD,had a sig-nificant trend of decreasing,but CA16 and other enteroviruses had a trend of steady increasing. Except the year of 2010, Distribu-tion of HFMD pathogenic bacteria between sexes had no significant difference(P>0.05). The distribution of HFMD pathogenic bacteria between rural and urban areas had significant difference(P<0.05) except in 2013. Conclusion Pathogen constitution of HFMD in Luoyang has a variation trend in 2009-2013,and the distribution has significant difference between rural and urban area. Therefore,in order to prevent and control HFMD well,it is necessary to detect the pathogen of HFMD timely and analyze the epidemic reasons.