2012年武汉地区手足口病肠道病毒分型与临床特征分析

Enterovirus Types and Clinial Characteristics of Hand,Foot,and Mouth Disease in Wuhan Area,2012

目的:了解武汉地区手足口病肠道病毒分型和临床特征,为手足口病预防及治疗提供依据。方法:采集手足口病患者咽拭子标本,采用实时荧光定量法检测CA16、EV71和通用型肠道病毒,同时搜集手足口病患儿的临床资料,分析不同病毒型手足口病患儿临床特征。结果:2012年1-12月共收集手足口病咽拭子标本3 083例,其中EV71阳性765例,阳性率为24.81%;CA16病毒阳性559份,阳性率为18.13%;EV71和CA16双阳性61例,阳性率为1.99%;通用型肠道病毒阳性1 698例,阳性率55.07%。1-3岁是手足口病高发年龄段,各病毒型均表现为男性多于女性。3 083例手足口病患者,临床上均有手、足、口或臀部皮疹,大部分患者有发热,部分患者伴有神经系统症状。EV71感染者出现发热、神经系统症状及白细胞增多的比例高于CA16和通用型肠道病毒阳性者。通用型肠道病毒阳性患者出现肺部并发症比例多于EV71感染者。结论:武汉市2012年手足口病主要由EV71、CA16及通用型肠道病毒引起,且以通用型肠道病毒为主。了解不同病毒型手足口病临床特征,对于手足口病预防和治疗具有重要意义。

Objective： To investigate the human enterovirus types and the clinical characteristics of hand foot and mouth disease （HFMD）, and to provide the data for the epidemic control and patient care. Methods： Throat swab samples were collected from 3 083 HFMD cases, and EV71, CoxA 16 and universal enteroviruses were detected by Real-time PCR. Clinical data were collected. Results： Among 3 083 HFMD samples, 24.81% were infected by EVT1, 18.13% were infected by CA16, 1.99% were infected by both, and 55.0% were infected by universal enteroviruses. The peak incidence of HFMD appeared in the age groups of 1-3 years old, and male patients were more than female patients. All 3 083 cases showed hands, feet, mouth and buttock rash. Most patients had fever and some neurological symptoms. The proportion of fever and neurological symptoms in EVT1 infection was higher than in CA16 and universal enteroviruses. The proportion of pulmonary complications in universal enteroviruses was in EVT1. Conclusion： HMFD in Wuhan were caused by EV71, CA16 and universal enteroviruses, and universal enteroviruses wasthe most common type during 2012. Understanding the clinical characteristics of each virus type of HFMD plays an important role in the surveillance and control of HFMD.