2014年昆明某三甲医院手足口病病原及流行特征分析

Analysis on etiology and epidemiological characteristics of hand-foot-mouth disease in a class 3A hospital in Kunming during 2014

目的对2014年昆明市延安医院就诊的手足口病（HFMD）病例进行回顾性分析总结,了解其病原分布及流行病学特点。方法应用实时荧光定量PCR对130例手足口病临床诊断病例的粪便标本进行病毒核酸检测,并对其年龄分布特点、季节分布情况进行分析。结果非重复性的130例临床诊断病例中,病原阳性检出79例,总阳性率为62.2%,其中EV71占检出病原的5.1%（4/79）,CA16占检出病原的17.7%（14/79）,其他型占77.2%（61/79）。4个年龄组中,1～3岁组和3～6岁组高于0～1岁、〉6岁组,4年龄组间阳性率比较差异有统计学意义（P〈0.05）。5～7月为HFMD发病高峰期,在全年发病例数及全年阳性检出例数的构成比中均为最高,8月开始发病例数有减少趋势,但12月又有所增加。结论手足口病5～7月为发病高峰期,以6月为最高;发病率以幼儿及学龄前儿童（2～6岁）为最高。

Objective To retrospectively analyze and summarize the children cases of hand,foot and mouth disease（HFMD）in our hospital during 2014 for understanding its etiological distribution and epidemiological characteristics.Methods The stool samples in children cases of clinically diagnosed HFMD were collected and performed the viral nucleic acid detection.The age distribution characteristics,season distribution situation were analyzed.Results Among 130 cases of non-repetitively clinically diagnosed HFMD,the pathogen positive detection was in 79 cases with the total positive rate of 62.2%,in which EV71 accounted for 5.1%（4/79）of detected pathogens,CA16 accounted for 17.7%（14/79）and the other types accounted for 77.2%（61/79）.In 4age groups,the positive detection rate in the 1-3years old group and the 3-6years old group was higher than that in the 0-1years old group and the〉6years old group,the positive detection rate had statistical difference among 4age groups（P〈0.05）.May to July was the peak period of HFMD onset,its constituent ratio to the full year onset cases and full year positive detection cases was highest.The onset cases number of HFMD began to reduce in August,but it increased again in December.Conclusion May to July is the peak period of HFMD onset,especially in June.The incidence rate of HFMD is highest in infants and preschool children（2-6years old）.