北京市朝阳区部分婴幼儿肠道病毒71型感染率及手足口病发病情况分析

Infection rate of enterovirus 71 and incidence of hand-foot-mouth disease in partial infants in Chaoyang District,Beijing City,China

目的分析北京市朝阳区部分婴幼儿肠道病毒71型（enterovirus 71,EV71）感染率及手足口病（hand-foot-mouth disease,HFMD）发病情况。方法选择北京市朝阳区小红门、酒仙桥社区6-35月龄健康婴幼儿为观察对象,共采集血清414份,检测中和抗体水平,并采集符合＂可疑肠道病毒病＂入选标准患者的咽拭子和肛拭子标本,应用RT-PCR法进行其他肠道病毒EV-G、柯萨奇病毒A16型（Coxsackie virus type A16,CA16）、EV71特异性核酸筛查。同时对观察对象进行1年随访,调查HFMD发病情况。将观察对象分为6-11月、12-17月、18-23月、24-29月、30-35月5个月龄组。结果 414名观察对象中,EV71中和抗体阳性39人,阳性率为9.42%,随着月龄的增加,阳性率呈递增趋势（P〈0.001）;男性婴幼儿EV71中和抗体阳性率为8.90%（17/191）,女性为9.87%（22/223）,二者差异无统计学意义（P〉0.05）。414名观察对象中,29例肠道病毒阳性,其中女性14例,男性15例,男女发病比例为1.07：1;CA16感染率为31.03%（9/29）,EV71感染率为17.24%（5/29）,其他肠道病毒感染率为51.72%（15/29）。尚不能认为男女性别间肠道病毒感染及EV71和CA16感染的构成比有差别,也不能认为EV71中和抗体情况对肠道病毒感染率和EV71发病率有影响;随着年龄的增长,EV71感染人数呈递增趋势,而CA16则保持不变;小红门社区EV71中和抗体阳性率（12.25%）与酒仙桥社区（4.45%）差异有统计学意义（P〈0.05）。结论月龄越大,婴幼儿血清EV71抗体阳性率越高;小红门和酒仙桥地区检测到的HFMD患儿主要病原体为CA16和EV71,且CA16感染率高于EV71感染率。

Objective To analyze the infection rate of enterovirus 71（EV71） and incidence of hand-foot-mouth disease（HFMD） in partial infants in Chaoyang District,Beijing City,China. Methods A total of 414 serum samples were collected from infants at ages of 6 - 35 months in Xiaohongmen and Jiuxianqiao Communities of Chaoyang District,Beijing City,and determined for neutralizing antibody level. The pharynx and anus swabs of suspected patients with intestinal virus diseases were collected and screened for specific nucleic acids to EV-G,Coxsackie virus type A16（CA16）and EV71. The subjects were followed up for one year and investigated for incidence of HFMD. The subjects were divided into five age groups,i.e. 6 - 11,12 - 17,18 - 23,24 - 29 and 30 - 35 months. Results Of the 414 samples,39 were positive for EV71 neutralizing antibody,indicating a positive rate of 9. 42%. The positive rate showed an increasing tendency with the increasing months（P 〉0. 001）. The positive rates of neutralizing antibody against EV71 was 8. 90%（17 / 191）in male and 9. 87%（22 / 223）in female infants,which showed no significant difference（P 〉0. 05）. Of the 414 patients,29 were positive for EVs,including 14 female and 15 male,indicating a sex ratio of 1. 07 ∶ 1. The infection rates of CA16,EV71 and other EVs were 31. 03%（9 / 29）,17. 24%（5 / 29）and 51. 72%（15 / 29）respectively. No significant composition rate was observed in the sex ratios of infection rates of EVs,EV71 and CA16. The EV71 neutralizing antibody showed no considerable effect on infection rate of EVs and incidence of HFMD caused by EV71.The number of subjects infected with EV71 increased with the increasing age,while that with CA16 showed no significant change. The neutralizing antibody positive against EV71 was 12. 25% in Xiaohongmen Community and 4. 45% in Jiuxianqiao Community,which showed significant difference（P 〈0. 05）. Conclusion The serum antibody positive rate against EV71 in infants increased with the increasing age. The major pathogens of HFMD in infants in the two communities were CA16 and EV71,while the infection rate of the former was higher than that of the latter.