目的对2012年4月至9月手足口病（HFMD）流行期间对449例HFMD患儿的临床特点及病原学流行特征进行分析，旨在为手足口病的防治工作提供依据。方法收集449例手足口病患儿资料，用荧光定量RT-PCR法进行肠道病毒通用型、肠道病毒71型（EV71）和柯萨奇病毒A组16型（CA16）定量分型。结果449例HFMD临床诊断病例中，肠道病毒通用型阳性数为331例，包含203例EV71型和109例CA16型，肠道病毒总阳性率为69.5％（331/476），其中EV71占42.6％（203/476），CA16占22.9%（109/476），EV71/CA16两者兼有者占3.8%（18/476），非EV71、CA16的其他肠道病毒占4.6%（22/476）。2012年送检标本中EV71与CA16检出率的差异无统计学意义（χ2=1.432，P=0.231）。结论2012年HFMD患儿以EV71型和CAl6型流行为主。而重症手足口病多发生于年龄<3岁的儿童，且重症患儿基本为EV71型感染。故小年龄组HFMD患儿应成为HFMD流行期间重点监测对象，并给予积极治疗，以防止成为重症HFMD患儿，从而降低重症HFMD病死率。%Objective To analyze epidemic characteristics of the etiological agents and its clinical significance in children with hand,foot and mouth disease(HFMD),during April-September 2012 in Children's Hospital,which is helpful for the Hangzhou HFMD prevention work. Method Information of 449 patients during the 2012 epidemic of HFMD in our hospital was collected,quantitative RT-PCR using fluorescent universal enterovirus,enterovirus 71(EV71)and Coxsackie virus A16(CA16)quantitative genotyping. Results The positive rate of enterovirus universal type in 449 patients with HFMD was 69.5%(331/476),which EV71,CA16,EV71/CA16 and other enterovirus were 42.6%(203/476),22.9%(109/476),3.8%(18/476)and 4.6%(22/476).The positive rate between EV71 and CA16 was not statistically significant in the cases of 2012(χ2=1.432,P=0.231).Conclusion CA16 and EV71 were the major etiological agents of the HFMD outbreak in our hospital from April 2012 to September 2012.Children under 3 years of age are risk factors for severe HFMD, and the children with severe HFMD are infected with EV71.So younger children should be monitored in the HFMD epidemic periods,and given the active treatment,to reduce mortality in severe patients.
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