肠道病毒EV71感染后标志物变化特点分析

Characteristics analysis of markers and changes after Enterovirus 71 infection

目的 观察分析手足口病常见病原肠道病毒71型（enterovirus71,EV71）早期检测效果及其随病程进展感染标志物变化特点.方法 整群抽样手足口病住院病例249人及健康对照50人,调查信息,跟踪采样,采集肛拭子和血清标本,分别检测EV71、柯萨奇病毒A16组（coxsackie virus 16 0f groups A,CA16）病毒RNA和免疫球蛋白M（immuoglobulin M,IgM）抗体,录入数据库后用SPSS 13.0进行统计学分析.结果 入院诊断手足口病249人中肠道病毒检出者167人（67.1％）,EV71和CA16双重感染14人（5.6％）,未检出肠道病毒者51人（20.5％）;早期检测患儿肛拭子EV-RNA和血清IgM,其中EV71感染检出效果两法差异无统计学意义（x2=0.01,P=0.928）;病程第3 d EV71-IgM检出超过80％,第6d可达100％,第6～7d抗体滴度达峰值,第8d以后低度下降,检出率降低.结论 手足口病早期实验室病原检测中,EV71-IgM在病程第3d后的检出与病毒RNA检出率符合性较高.

Objective To analyze the markers and Change after EV71 infection in hand-foot and mouth disease （HFMD）. Methods Cluster sampling was used to recruit 249 hospitalized cases of HFMD and 50 cases of healthy chil- dren as controls, clinical information, rectal swabs and serum samples were also collected, EVT1 and CoxA16 virus RNA and IgM antibodies were detected, statistical analysis were by SPSS 13.0. Results Among 249 cases of clinical diagnosed HFMD, 198 cases （79. 5% ） were detected enterovirus RNA from swabs, 14 cases （5.6%） were detected EV71 and CA16, 51 cases （20. 5% ） were not detected any enterovirus. In early infected patients, EV-RNA detected from rectal swab and EV-IgM detected from serum, there was no significant difference in the two methods in detecting EVT1 infection （Z2 = 0. 01, P = 0. 928）. In addition, EV71-IgM positive rate were 80% to 100% in patients serum from the third day to the sixth day after the onset, but after eight days, EV71-IgM positive rate was reduced in patients. Conclusions In early laboratory detected pathogen of HFMD, EV71-1gM positive rate were in coincidence with positive rate of EV71-RNA.