2011-2013年手足口病病原谱及临床特征分析

Analysis of the pathogenic characteristics of hand-foot-mouth disease in Beijing during 2011-2013

目的：探讨2011-2013年手足口病（HFMD）病原体变化趋势。方法采集4064例在我院就诊的HFMD患者的咽拭子标本并提取核酸，采用实时荧光定量PCR方法检测肠道病毒通用型（EV），肠道病毒71型（EV71）及柯萨奇病毒A组16型（CA16）。结果3年间6岁以上患儿占96.0%；发病以5~7月份为主，占73.5%。2011-2013年HFMD 患者 EV71、CA16和未分型肠道病毒的检出率依次为42.6%、35.3%、18.5%，16.1%、22.6%、11.5%，41.3%、42.1%、70.0%，差异有统计学意义（x2=343.3，P＜0.05）。2013年EV71、CA16检出率明显低于2011、2012年，未分型病毒检出率明显增高（P均＜0.017）。613例重症HFMD患儿中，EV71感染占59.2%、CA16感染占11.1%，未分型病毒感染占29.7%，且均以肺炎合并脑干脑炎为主。结论2011-2013年HFMD病原谱发生了变化，未分型肠道病毒增多，需引起重视。

Objective To study the pathogenic characteristics of hand-foot-mouth disease （HFMD）by detecting the specimens isolated from the patients during 2011-2013, and to observe the new trend of this disease. Methods A total of 4 064 clinical specimens were collected from HFMD patients and then viral isolations were performed, the positive viral isolates were identified by using the real-time PCR method（detecting EV, EV71 and CA16）. Results The ration of chil-dren under 6 years old was 96.0%. The amount of patients in May to July occupied 73.5% in the 3 years.The detection rates between EV71, CA16 and unclassified enteroviruses were statistical significance during those 3 years （x2=343.3, P〈0.05）. The detection rate of EV71, CA16 in 2013 was significantly lower than 2011 and 2012, the detection rate of unclas-sified enteroviruses in 2013 was significantly higher than 2011 and 2012 （all P＆lt; 0.017）. In the 613 serious HFMD chil-dren, EV71 infection was 59.2%, CA16 infection was 11.1%, and unclassified enteroviruses infection was 29.7%. Conclu-sion The pathogenic characteristics of HFMD has changed during the 3 years. Patients infected with unclassified en-teroviruses have increased.More attention should be paid to these patients.