178例手足口病临床诊断病例检测结果分析

Analysis of 178 clinical cases with hand-foot-mouth disease

目的分析两种不同方法检测手足口的灵敏度,探索手足口临床症状与检测结果的关联。方法收集手足口病临床诊断病例咽拭子标本,用Real-Time PCR方法检测标本中肠道病毒核酸,采用人横纹肌瘤细胞(RD)进行病毒分离。结果 178例临床诊断手足口病病例中,114份Real-Time PCR检测阳性,阳性率为64.0%,28份病毒分离阳性,阳性率为15.7%;核酸检测阳性与阴性的临床诊断病例间的各临床症状未见显著差异(P>0.05);随着患者双手皮疹数的升高,病毒细胞分离阳性率显著升高(χ2=9.590,P=0.008)。结论 Real-Time PCR方法灵敏度明显高于细胞分离,Real-Time PCR应成为实验室检测手足口病的首选方法,病毒分离阴性不能作为实验室检测手足口病的最终结果;选择双手皮疹较多的患者采集咽拭子标本,可以提高HFMD病毒分离的阳性率。

Objective To compare the sensitivity of two methods in detection of hand - foot - mouth disease （ HFMD）, and to analyze the relationship between clinical symptoms and laboratory diagnosis of HFMD cases. Methods Throat swabs specimens were collected from 178 clinical HFMD cases to detect the nucleic acid of enterovirus by real -time PCR, while virus was isola- ted with rhabdomyoma（RD） cells. Results In 178 clinical HFMD cases, 114 cases were positive by Real -time PCR, ac- counting for 64.0% ; Enterovirus was isolated from 28 cases, the positive rate was 15.7%. The clinical symptoms had no obvi- ous difference between nucleic acid positive cases and negative cases among these 178 clinical HFMD cases（P 〉 0.05）. The ra- shes increase was positively correlated with virus isolation rate in HFMD cases （X2 = 9. 590, P = 0. 008）. Conclusion Real - time PCR is more sensitive than RD cells isolation, superior to other methods for HFMD detection in laboratory. Virus isolation negative can not be used as the final result of laboratory diagnosis. In order to get a higher isolation rate of the enterovirus, throat swabs specimens should be better collected from HFMD cases with more rashes in hands.