武威市2008-2014年手足口病发病及病原学特征研究

Epidemiological and etiological features of hand-foot-mouth disease in Wuwei in 2008-2014

目的了解武威市2008-2014年手足口病（HFMD）发病及病原学情况,为制定有效的防控策略提供实验室依据。方法对武威市2008-2014年HFMD发病情况进行分析。采集临床诊断患者粪便、肛试子和咽拭子样本,应用RT-PCR检测肠道病毒核酸并分型。采用描述流行病学方法,分类变量资料采用χ^2=验,P〈0.05为差异有统计学意义。结果武威市2008-2014年报告HFMD年均发病率和死亡率分别为48.14/10万和0.015/10万,各年报告发病率无明显变化趋势。武威市2008-2014年共送检HFMD样本841份,阳性率43.76%;其中EV71型阳性率18.55%,CoxA16型阳性率16.53%,其他肠道病毒阳性率为8.68%;肠道病毒阳性检出率总体呈上升趋势,不同年份肠道病毒检出阳性率（χ^2=63.624,P=0.000）和肠道病毒型别构成（χ^2=187.849,P=0.000）差异均有统计学意义。肠道病毒阳性检出率由高到低依次为古浪县（81.58%）,天祝县（79.33%）、民勤县（60.00%）和凉州区（29.67%）,不同地区肠道病毒检出阳性率（χ^2=171.330,P=0.000）和肠道病毒型别构成（χ^2=49.45,P=0.000）差异均有统计学意义。结论武威市手足口病病原主要为EV71和CoxA16,随时间推移CoxA16检出率增加,不同地区病原学型别存在一定的差异。

Objective To understand the epidemiologieal and etiological characteristics of hand-foot-mouth disease （HFMD） in Wuwei from 2008 to 2014, and to provide laboratory evidence for its prevention and control. Methods Clinical data of cases with HFMD were collected and analyzed from 2008 to 2014 in Wuwei city. Fecal samples as well as anus and throat swabs of patients were collected and were tested by RT-PCR for nucleic acid of intestinal virus. Chi-square test was used for data statistical analysis. Results The average annual morbidity and mortality were 48.14 and 0. 015 per 100, 000 population from 2008 to 2014 with no significant annual change. A total of 841 samples were tested with the overall positive rate of 43.76%, 18.55% for EV71, 16. 53% for CoxA16 and 8.68% for other enterovirus. The positive rate and types of intestinal virus changed significantly each year with an upward trend （x^2=63. 624, P=0. 000） （X2 =187. 849, P=0. 000）. The highest positive rate of intestinal virus was found in Gulang county （81.58%）, followed by Tianzhu County （79.33%）, Minqin county （60.00%） and Liangzhou district （29.67%） . There was geographical change of positive rate （x^2=171.330, P=0.000） and virus types （x^2=49.45, P=0.000）. Conclusions The major pathogen of HFMD are found to be EV71 and CoxA16 in Wuwei, and the detection rate of CoxA16 increases. The virus type varies geographically.