贵州省手足口病的流行病学特征及病原鉴定

Analysis on epidemic feature and etiological identification of Hand-foot-mouth disease in Guizhou province

目的了解贵州省手足口病的流行趋势及病原的型别分布情况。方法对2008年4-12月88例临床诊断手足口病例进行临床特征及三间分布分析,采用细胞分离结合逆转录-聚合酶链反应(RT-PCR)鉴定肠道病毒的病原体。结果88例患者中有、无发热症状比例约为2∶1,就诊时口腔、手掌及足底同时出疹率占51.93%;患者居家与住院治疗比例约为10∶1,乡村与城市发病比例约为3∶1。2008年手足口病发病率以贵阳市最高(66.44/10万),5-8月为发病高峰,高发年龄为1～5岁组,男女比例为2∶1。临床标本病毒分离阳性率达35.34%(EV71∶CAl6为2∶1)。疱疹液及咽拭子在发病2d内病毒检出率最高,占各自阳性的71.42%及52.17%。3～7d采集粪便病毒检出率高。结论手足口病的流行有明显的地域、季节及年龄界限,聚集病例以EV71感染为主,同时伴有CA16感染。

Objective To study the epidemic feature and the etiological distribution of the hand- foot-and-mouth Disease in Guizhou province. Methods To analyze the 88 infectors clinical features and the region, season and age distributions for hand-foot-and-mouth patients diagnosed by clinicians in Guizhou province during April and December, 2008. The pathogen of enteocvirns was indentified by reverse transcriptase PCR （RT-PCR） after cellular segregation combine. Results In 88 infectors, Ratio of fever to non-fever was 2 ： 1. The clinical features showed that the oral-mucosal pox or ulcer as well as hand and foot rashes had got the 51.93% incidence rate. The ratio of patients were treated at home to in hospital was 10 ： 1. Meanwhile, the patients were live in village to city was 3 ： 1. The children lived in Guiyang of Guizhou had got the highest incidence rate of Hand-foot-mouth disease （66.44/100,000）, the peak-incidence rate during May and August, and the distinct outbreak age was 1-5, boys to girls was 2 ： 1,2008. The viral culture positive ratio of clinical specimens was 35.34% （The ratio of infecting EV71 to CA16 was 2 ： 1. The herpes liquid and throat swab were get the highest viral positive ratio, were 71.42% and 52.17%. Taking the herpes liquid and throat swab in 2 days could get the highest positive rate, but the faeces was 3- 7 days. Conclusion The epidemic of hand-foot-and- mouth disease had distinct restriction for regions, seasons and ages. EV71 was prior to CA16 as the main etiological agent,