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手足口病流行期间主要病原体所致疱疹性咽峡炎的临床分析 被引量:4

Clinical analysis of herpangina caused by major pathogens during outbreak of hand-foot-mouth disease
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摘要 目的 对手足口病流行期间主要病原体所致疱疹性咽峡炎进行临床分析.方法 收集94例手足口病流行期间住院的疱疹性咽峡炎患儿的临床资料,采用实时-聚合酶链反应技术检测肠道病毒71型(EV71)、A组柯萨奇病毒16型(CoxA 16)感染情况,并进行相关指标比较.结果 94例疱疹性咽峡炎患儿中,EV71阳性34例(36.17%,34/94)(EV71阳性组),CoxA 16阳性31例(32.98%,31/94)(CoxA 16阳性组).EV71阳性组和CoxA 16阳性组白细胞计数、空腹血糖、红细胞沉降率、超敏C反应蛋白均较正常明显升高,但两组间比较差异无统计学意义(P>0.05);而心肌酶谱、肌酐、尿素氮在正常范围内,两组间比较差异无统计学意义(P>0.05).EV71阳性组和CoxA 16阳性组年龄<3岁比例、持续高热(腋温> 39℃)的发生率比较差异无统计学意义(P>0.05),而EV71阳性组神经、呼吸、循环系统异常的发生率明显高于CoxA 16阳性组[26.47% (9/34)比6.45%(2/31)、23.53%(8/34)比3.23%(1/31)、20.59%(7/34)比3.23%(1/31)],差异有统计学意义(P<0.05).94例疱疹性咽峡炎患儿中,11例为重症(11.70%,11/94),EV71阳性组9例,CoxA16阳性组2例.2例因肺出血死亡,出现瘫痪1例,均为EV71阳性组.结论 同一时期疱疹性咽峡炎与手足口病的主要病原体可能具有平行性,手足口病流行期间的疱疹性咽峡炎患儿应纳入到手足口病来进行统一管理;而且EV71阳性患儿病情较CoxA 16阳性患儿重,检测病原体有助于判断预后. Objective To analyze the clinical characteristics of herpangina caused by major pathogens during outbreak of hand-foot-mouth disease (HFMD).Methods The clinical data of 94 patients with herpangina during outbreak of HFMD were collected.Enteroviruses 71 (EV71) and Coxsackie virus A16 (CA16) were detected by real-time polymerase chain reaction.And relevant indicators of two groups were compared.Results There were 34 cases EV71 positive (36.17%,34/94,EV71 positive group) and 31 cases CoxA 16 positive (32.98%,31/94,CoxA 16 positive group) from the results of pathogen detection.The level of white blood cell count,glucose,erythrocyte sedimentation rate,hypersensitive C-reactive protein were increased obviously than normal,while no significant difference was found between two groups (P 〉 0.05).The level of myocardial enzymes,creatinine,blood urea nitrogen were in the normal range and no significant difference was found between two groups (P 〉 0.05).There was no significant difference between two groups in the incidence of age 〈 3 years old,persistent high fever (P 〉 0.05).The abnormalities performance in the nervous,respiratory,circulatory system of the EV71 positive group were significantly higher than those in CoxA 16 positive group [26.47% (9/34) vs.6.45% (2/31),23.53% (8/34) vs.3.23%(1/31),20.59% (7/34) vs.3.23% (1/31) separately],and there were significant differences between two groups(P 〈 0.05).There were 11 severe cases (11.70%,11/94) in the 94 cases of children with herpangina,and 9 cases belonged to the EV71 positive group,2 cases belonged to the CoxA16 positive group.Two cases died of lung hemorrhage,1 case occurred of paralysis,all of them were detected EV71 positive.Conclusions The pathogen of herpangina might be same as the pathogen during the outbreak of HFMD.Children with herpangina during outbreak of HFMD should be incorporated into the management of HFMD.EV71 positive children are serious than CoxA16 positive cases,and detecting pathogens will be helpful to determine the prognosis.
作者 王竞芳
出处 《中国医师进修杂志》 2014年第33期27-29,共3页 Chinese Journal of Postgraduates of Medicine
关键词 疱疹性咽峡炎 手足口病 临床分析 病原体 Herpangina Hand-foot-mouth disease Clinical analysis Pathogens
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参考文献7

  • 1Wang SM,Lei HY,Liu CC. Cytokine imnmnopathogenesis of enterovirus 71 brain stem encephalitis [J]. Clin Dev Immunol, 2012,2012 : 876241.
  • 2Choi CS,Choi YJ,Choi UY,et al. Clinical manifestations of CNS infections caused by enterovirus type 71 [J]. Korean J Pediatr, 2011,54( 1 ) : 11-16.
  • 3胡亚美,江载芳.诸福棠实用儿科学[M].7版.北京:人民卫生出版社,2005.1143-1152.
  • 4手足口病诊疗指南(2010年版)[J].国际呼吸杂志,2010,30(24):1473-1475. 被引量:1072
  • 5肠道病毒71型(EV71)感染重症病例临床救治专家共识[J].中华儿科杂志,2011,49(9):675-678. 被引量:408
  • 6Park K, Lee B, Baek K, et al. Enteroviruses isolated from herpangina and hand-foot-and-mouth disease in Korean children [J]. Virol J, 2012,9:205.
  • 7Mirand A, Henquell C, Archimbaud C, et al. Outbreak of hand, foot and mouth disease/herpangina associated with coxsackievirus A6 and AIO infections in 2010, France : a large citywide, prospective observational study [J]. Clin Microbial Infect,2012,18 (5): 110- 118.

二级参考文献36

  • 1Chang LY. Enterovirus 71 in Taiwan. Pediatr Neonatol,2008,49 : 103-112.
  • 2Cho HK, Lee NY, Lee H. Enterovirus 71-associated hand, foot and mouth diseases with neurologic symptoms, a university hospital experience in Korea, 2009. Korean J Pediatr,2010,53:639-643.
  • 3Koroleva GA, Lukashev AN, Khudiakova LV. Encephalomyelitis caused by enterovirus type 71 in children. Vopr Virusol,2010,55 : 4-10.
  • 4Chang LY, Lee CY, Kao CL. Hand, foot and mouth disease complicated with central nervous system involvement in Taiwan in 1950-1951 . J Formos Med Assoc,2007,106 : 173-176.
  • 5Wintergerst KA, Buckingham B, Gandrud L, et al. Association of hypoglycemia, hyperglycemia, and glucose variability with morbidity and death in the pediatric intensive care unit. Pediatrics,2006, 118 : 173-179.
  • 6Preissig CM, Rigby MR. Hyperglycaemia results from beta-cell dysfunction in critically ill children with respiratory and cardiovascular failure: a prospective observational study. Critical Care ,2009,13 : R27.
  • 7Ooi MH, Wong SC, Lewthwaite P, et al. Clinical features, diagnosis, and management of enterovirus 71 . Lancet Neurol, 2010,9:1097-1115.
  • 8Weng KF, Chen LL, Huang PN, et al. Neural pathogenesis of enterovirus 71 infection . Microbes and Infection, 2010,12 : 505- 510.
  • 9Wang SM, ki HY, Huang MC, et al. Modulation of cytokine production by intravenous immunoglobulin in patients with entemvinm 71 associated bminstem ence-phalitis. J Clin Viml, 2006,37:47-52.
  • 10Mayer SA, Lin J, Homma S, et al. Myocardial Injury and Left Ventricular Performance After Subarachnoid Hemorrhage. Stroke, 1999,30:780-786.

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