杭州市萧山区2013—2015年手足口病病原谱分析

Analysis of Pathogen Spectrum of Hand, Foot and Mouth Disease in Xiaoshan District of Hangzhou from 2013 to 2015

目的了解2013—2015年杭州市萧山区手足口病的病原体型别及分布特征,为进一步掌握疫情动态提供依据。方法采用实时荧光逆转录PCR(RT-PCR)方法对辖区内232例手足口病临床诊断病例标本进行病原体检测,并结合患儿临床资料分析检测结果。结果 232份标本中共检出肠道病毒(EV)阳性结果 150份,阳性率为64.66%;其中肠道病毒71(EV71)阳性结果 32份,柯萨奇病毒A组16型(Cox A16)阳性结果 26份,分别占EV阳性标本的21.33%、17.33%;非典型肠道病毒阳性结果 92份,所占比例为61.33%,已占据主导地位;5岁及其以下儿童EV感染占所有感染者的98.00%;不同性别患儿EV、EV71和Cox A16阳性率差异无统计学意义(P>0.05);患儿的主要临床症状是发热伴随疱疹。结论引起萧山区手足口病的病原谱出现较为明显的变化,应加强对非典型肠道病毒的监测。5岁及其以下儿童是EV感染的高危人群,需要加强对该类人群的防控力度,做到早发现、早隔离、早治疗。

Objective To understand etiological classification and distribution features of hand, foot and mouth disease（HFMD） in Xiaoshan district of Hangzhou, in order to provide the references for preventing and controlling the HFMD disease. Methods A total of 232 HFMD specimens confirmed by clinical measures were detected by using reverse transcription polymerase chain reaction（RT-PCR）, then analysis laboratory results combining with children＇s clinical data. Results The150 specimens were positive to enterovirus, and the positive rate was 65.59%. Furthermore, in the above results, there were32 cases positive to enterovirus 71 and 26 cases positive to coxsackievirus A16, and the positive rates were 21.33% and17.33% respectively. The positive rate of atypical enterovirus was 92 cases, dominated with 61.33%. Most of the HFMD patients were below the age of 5, which accounted for 98.00% to all the infectious patients. There was no statistical significance between genders in positive rates of enterovirus, enterovirus 71 and coxsackievirus A16（P〉0.05）. Fever with herpes was the main clinical symptom in HFMD patients. Conclusion The pathogenic spectrum of HFMD in Xiaoshan was obviously changed, and the monitoring of atypical enterovirus should be strengthened. The children below the age of 5 were high risk group, needed to strengthen the supervision of this class of people, to achieve early detection, early isolation, early treatment.