2010-2013年济南市历城区414例手足口病病例分析

Analysis on case characteristics and etiological changes of 414 hand-foot-mouth disease in Licheng District,Jinan,in 2010-2013

目的：分析2010-2013年济南市历城区手足口病（HFMD）病例特征和病原学变化。方法病例调查采用面对面方式，病原学检测应用实时荧光定量PCR方法。结果共调查2010-2013年HFMD病例414例，1～5岁儿童占85．99％（356/414），男女性别比为1．59∶1。病例皮疹主要分布在手、口、足、臀等部位，38．89％的病例伴有发热。阳性标本342份，阳性检出率为82．61％。发病后7 d内采样标本阳性检出率显著高于7 d后采样阳性率（84．76％ vs 62．50％，χ2＝12．46，P＜0．001）。不同年份之间病原学构成差异有统计学意义（χ2＝39．45，P＜0．001）。结论济南市历城区HFMD多发生在1～5岁儿童，近40％的病例伴有发热，优势病原型别为肠道病毒71（EV71）型和柯萨奇病毒A16（CoxA16）型，两者在不同年份之间呈现交替流行的现象，其他肠道病毒在HFMD致病中也扮演着重要角色，值得今后进一步开展研究工作。

Objective To analyze the case characteristics and etiological changes of hand-foot-mouth disease （HFMD） in Licheng District,Jinan,in 2010-2013.Methods HFMD cases were surveyed by face-to-face method.The real-time PCR was used to detect human enterovirus nucleic acid.Results A total of 414 cases were surveyed,and chil-dren aged 1-5 years accounted for 85.99%（356/414）.Male to female ratio was 1.59∶1.Rash mainly distributed in hands,mouth,feet and buttocks.There were 38.89% of the cases accompanied by fever.A total of 342 specimens were tested positive,and the positive rate was 82.61%.The specimen positive rate sampling within 7 days was signifi-cantly higher than that after 7 days （84.76%vs 62.50%,χ2 =12.46,P＆lt;0.001）.There were statistical differences in etiology constituent in different years （χ2 =39.45,P＆lt;0.001）.Conclusion HFMD mainly occurs in children aged 1-5 years in Licheng District,Jinan.Nearly 40%of the cases are with fever.The advantage pathogen types are Entero-virus 71 （EV71）and Coxasckie virus A16 （CoxA16）,both alternately popular in different years.Other enteroviruses also play an important role in HFMD pathogenesis,worthy of further developing research work in the future.