2012～2013年杭州市萧山区手足口病病原谱及临床特征分析

摘要

Objective To understand the pathogens spectrum and clinical characterization of hand ,foot and mouth disease (HFMD) in Xiaoshan District of Hangzhou .Methods A total of 253 specimens ,including 208 stool specimens and 45 throat swabs ,collected from May .2012 to Jul .2013 were detected for pathogens of HFMD by using real‐time reverse transcriptase polymerase chain reaction assay .Results The positive rate of enterovirus (EV)was 83 .17% ,and the percentages of EV71 ,Coxsackie virus A16 (CoxA16) and other EV subtypes were 55 .49% , 13 .29% and 31 .21% ,respectively .The positive rates of EV were without significant difference between male and fe‐male children (P>0 .05) .EV71 was predominant strain in patients ,who were less than 5 years old ,and other EV subtypes were predominant strains in patients ,who were more than 5 years old .Fever with herpes was the main clini‐cal symptom in HFMD patients ,and EV71 was primary pathogen causing fever with herpes ,vomiting or neurological and so on .The positive rate of EV in stool specimens was significant higher than that in throat swabs (P<0 .05) . Conclusion EV71 and other EV subtypes might be predominant strains of HFMD ,and the prevalence of CoxA16 might be with downtrend .Detection of EV ,EV71 and CoxA16 could be important for the control and prevention of HFMD .%目的：了解杭州市萧山区手足口病（H FM D ）病原谱及临床特征。方法采用荧光定量反转录聚合酶链反应，对2012年5月至2013年7月就诊的208例H FM D疑似患儿咽拭子标本（45份）和粪便标本（208份）进行病原体检测，结合患儿临床资料分析检测结果。结果208例患儿中，肠道病毒（EV ）检出率为83．17％，其中EV71、柯萨奇病毒A16（CoxA16）和其他EV亚型所占比例分别为55．49％、13．29％和31．21％；男、女性患儿EV检出率比较差异无统计学意义（P＞0．05）。5岁及其以下患儿以EV71感染为主，5岁以上患儿以其他EV亚型感染为主。HFMD患儿临床症状主要为发热伴疱疹，各种类型临床症状患儿均以EV71感染为主。粪便标本EV检出率高于咽拭子标本（P＜0．05）。结论 EV71和其他EV亚型是该地区 HFMD患儿常见病原体，CoxA16感染流行趋势有所下降。加强EV、EV71和CoxA16检测有助于 HFMD的预防和控制。