2010年昆明地区儿童手足口病的流行特征

Prevalent characteristics in children with hand-foot-mouth disease in the Kunming area in 2010

目的调查2010年昆明地区儿童手足口病(HFMD)的流行特征。方法收集2010年1～12月昆明市儿童医院门诊及住院的HFMD患儿13286例的临床资料进行回顾性分析。这些患儿中包括死亡病例8例、重症病例715例和普通病例12563例。结果人肠道病毒检出8200例,总阳性率为61.72%,其中人肠道病毒71型(EV71)占29.49%(2418/8200),柯萨奇病毒A16型(CoxA16)占53.21%(4363/8200),EV71和CoxA16混合感染占0.91%(75/8200),肠道病毒其他型占16.39%(1344/8200)。四个季度间人肠道病毒总阳性率差异有统计学意义(P<0.01),以第二季度总阳性率最高(71.56%),病例数也最多(52.94%)。EV71在重症组中占优势,CoxA16在普通组中占优势(P<0.01)。重症患儿多见于3岁以下儿童(P<0.01);EV71阳性病例中,死亡、重症与普通病例的EV71病毒载量差异无统计学意义(P>0.05)。结论 2010年昆明地区儿童HFMD以CoxA16感染为主,但感染EV71更易导致重症HFMD,且重症患儿集中在3岁以下儿童;病毒载量与患儿病情无关;全年发病高峰期在第二季度。

Objective To study the prevalent characteristics in children with hand-foot-mouth disease（HFMD） in the Kunming area in 2010. Methods The clinical data of 13286 outpatient and inpatient children with HFMD in Kunming Children′s Hospital between January and December,2010,including 8 death cases,715 serious cases and 12563 non-serious cases,were retrospectively studied. Results Human enterovirus was detected in 8200 children（61.72%）.Children infected with EV71 and CoxA16 accounted for 29.49%（2418/8200） and 53.21%（4363/8200）,respectively.Seventy-five children（0.91%） were found to have a mixed infection of the two viruses.Other types of human enterovirus were detected in 1344 children（16.39%）.There were significant differences in the total positive rate of human enterovirus in the four quarters of the year（P0.01）.The total positive rate in the second quarter represented the highest proportion（71.56%）,and the number of patients was also highest,accounting for 52.94% of the total number of patients in the whole year.EV71 infection was common in the serious case group while CoxA16 was found to be the main pathogen in the non-serious case group.Serious cases were common in children under three years old.In the positive EV71 cases,the viral load of EV71 was not statistically different between the death cases,serious and non-serious cases. Conclusions In 2010,children with HFMD in the Kunming area were mainly infected with CoxA16.Serious cases of HFMD were more common in those who were infected with EV71,and the majority of serious infections were suffered by children who were less than three years old.The viral load was not associated with disease severity.The highest morbidity rate was in the second quarter of the year.