2015年沈阳地区手足口病监测结果分析

Surveillance results and analysis of the hand-foot-mouth disease in Shenyang in 2015

目的了解沈阳地区手足口病发病情况及其病原谱的构成,为手足口病的诊断、治疗及其防控提供科学依据。方法应用荧光定量RT-PCR方法,收集2015年哨点医院临床诊断为手足口病的患者709例,进行标本检测。结果肠道病毒阳性率为66.01%(468/709);其中肠道病毒71型(EV71)阳性48例,阳性检出率为10.26%(48/468);柯萨奇病毒A组16型(CA16)阳性28例,阳性检出率为5.98%(28/468);非EV71/CA16型392例,阳性检出率为83.76%(392/468)。结论 2015年沈阳市手足口病病原谱发生变化,非EV71/CA16的肠道病毒成为优势流行株。分子生物学方法可用于手足口病的病原体检测、EV71比Cox A16分型以及接触者的排查,有利于感染者的早发现、早隔离,对手足口病的监测及防控具有重要作用。

Objective To investigate the incidence and the pathogenic spectrum composition of hand- foot- mouth disease（ HFMD） in Shenyang,so as to provide experimental basis for the clinical diagnoses and the medical treatment and control and prevention of HFMD. Methods Specimens from 709 clinical diagnosed hand food and mouth diseases patients from the sentinel hospitals in Shenyang in 2015 were detected by fluorescence- fix- quantify RT- PCR. Results The positive rate of entericvirus was 66. 01%（ 468/709）,including 48 enterovirus（ EV71） positive cases,28 coxsackieviruses16（ CA16） positive cases,392 EV positive cases with negative EV71 and CA16. Positive rate of EV71,CA16 and EV positive cases with negative EV71 and CA16 were 10. 26%（ 48/468）,5. 98%（ 28/468） and 83. 76%（ 392/468）. Conclusion Pathogen spectrum of HFMD in Shenyang in2015 has changed,and enteroviruses with negative EV71 and CA16 have become dominant epidemic strains. Molecular biological methods can be used for pathogenic diagnosis of the hand foot and mouth diseases,subtyping of Coxsackie A16 and Enterovirus71,and for investigation of contactors. It plays an important role in the surveillance and control of the hand foot and mouth diseases.