肠道病毒71型手足口病合并肺炎支原体感染179例临床分析

Clinical analysis of 179 cases of hand-foot-mouth disease caused by enterovirus type 71 and Mycoplasma pneumoniae

目的总结肠道病毒71型（EV71）手足口病（HFMD）合并肺炎支原体（MP）感染的临床特征。方法选取EV71引起HFMD患儿469例,其中单独EV71阳性290例为对照组,合并MP阳性179例为混合感染组,比较两组患儿临床表现、实验室检查结果差异。结果混合感染组以0～2岁发病最多（54.7%）,而对照组以2～5岁常见（49.3%）,两组患儿年龄分布差异有统计学意义（P〈0.01）。混合感染组重症病例发生率及谷草转氨酶、乳酸脱氢酶、肌酸激酶同工酶及肌钙蛋白Ⅰ水平均明显高于对照组（P〈0.01或0.05）。结论 MP混合感染可加重EV71引起HFMD病情,建议HFMD患儿作MP抗体检测。

Objective To summarize the clinical features of hand-foot-mouth disease （HFMD） caused by enterovirus type 71 （EV71） and Mycoplasma pneumoniae （Mp）. Methods A total of 469 children including 290 EV71-induced HFMD （control group） and 179 EV71 and Mp-induced HFMD （mixed infection group） cases were collecetd, and the clinical and laboratory findings between two groups were analyzed. Results The onset age was 0-2 years （54.7%） in mixed infection group and 2-5 years （49.3%） in control group, and showed a significant difference between both groups （P〈0.01）. Compared with control group, incidence of severe cases and levels of aspartate aminotransferase, lactic dehydrogenase, creatine kinase isoenzyme and troponin I were increased in mixed infection group （P〈0.01-0.05）. Conclusion Coinfection of Mp may aggravate the EV71- induced HFMD. It is suggested that MP antibody might be detected for all cases of HFMD.