2009—2012年保定市手足口病病原学分析

Analysis on pathogenic characteristics of hand-food-mouth disease in Baoding City from 2009-2012

目的了解保定市2009—2012年手足病(HFMD)病原学变化,为HFMD防控提供实验室依据。方法采用荧光定量RT-PCR方法对HFMD病例咽拭子标本进行肠道病毒通用型、EV71型以及CoxA16型核酸检测,应用Excel和SPSS 11.5对结果进行统计分析。结果 2 577例临床诊断HFMD病例中,检出肠道病毒阳性病例1 140例,其中EV71阳性构成比为52.37%,CoxA16阳性构成比为25.88%,其他肠道病毒阳性构成比为21.75%。2009—2011年病原以EV71为主,2012年EV71和CoxA16构成比相当,同时成为主要病原。全年均有阳性病例检出,4—8月为其高峰,阳性病例集中于5岁以下儿童,男性多于女性;但在病原构成上,女性EV71阳性构成比高于男性;CoxA16和其他肠道病毒阳性构成比无性别差异。结论 2009—2012年保定市HFMD主要病原是EV71和CoxA16,发病高峰在4—8月,5岁以下儿童为主要防护对象。

[ Objective ] To understand the pathogenic changes of hand-food-mouth disease （HFMD） in Baoding City from 2009-2012, provide the experimental basis for HFMD prevention and control. [ Methods] The fluorescent quantitation RT-PCR was used to test throat swab specimens for enterovirus （ EV）, enterovirus 71 （ EV71 ） , and coxsackievirusl6 （ CoxA16 ）. The results were statistically analyzed with SPSS 13.0 and Excel software. [ Results] 1 140 cases with enterovirus nucleic acid were detected in 2 577 confirmed HFMD cases, which EV71 ,CoxA16 and other enteroviruses accounted for 52.37%, 25.88% and 21.75%, respectively. EVT1 was the dominant pathogen from 2009 to 2011, while the constituent ratio of EV71 was equal to that of CoxA16 in 2012, and both of them were the main pathogens. The positive cases were detected throughout the year, and the peak season ap- peared April to August. A majority of cases were children below 5 years old, and the number of male cases was greater that that of female cases. The constituent ratio of EV71 in female cases was higher than that in male cases, and there were no significant differences in constituent ratio of CoxA16 and other enteroviruses between male and female cases. [ Conclusion] EV71 and CoxA16 are the main pathogens of HFMD in Baoding City from 2009 to 2012. The peak season is April to August. The prevention and control of HFMD should focus on children under 5 years old.