CA6阳性与EV71、CA16阳性手足口病患儿临床特征分析

Clinical characteristics of children with CA6 positive,EV71 positive and CA16 positive hand,foot and mouth disease

目的分析柯萨奇病毒A6型(CA6)阳性与肠道病毒71型(EV71)、柯萨奇病毒A16型(CA16)阳性手足口病患儿的临床特征。方法选取商洛市中心医院2014年1月至2016年12月收治的1 528例手足口病患儿,通过实时荧光定量聚合酶链反应法检测患儿肠道病毒核酸,以分析CA6、EV71、CA16三种病毒引起的手足口病患儿的临床特征。结果在1 528例手足口病患儿中,经病原学确诊出374例CA6阳性患儿、673例CA16阳性患儿、481例EV71阳性患儿。CA6阳性患儿发病平均年龄(t值分别为6.34、5.85)、齿龈部疱疹分布(χ~2值分别为5.65、5.23)均低于CA16、EV71阳性患儿(均P<0.05),且发热分布均高于CA16、EV71阳性患儿(χ~2值分别为8.56、8.23,均P<0.05)。CA6阳性患儿C反应蛋白和WBC升高分布均高于CA16、EV71阳性患儿(χ~2值分别为5.34、5.89;6.34、6.83,均P<0.05)。结论 CA6已发展成一种手足口病患儿新型的流行病原,且其临床特征与因EV71及CA16引起的手足口病有所不同,可作为临床诊断的依据。

Objective To analyze the clinical characteristics of children with coxsackievirus A6（ CA6） positive,enterovirus 71（ EV71）positive and coxsackievirus A16（ CA16） positive hand,foot and mouth disease（ HFMD）. Methods Altogether 1 528 children with HFMD admitted in Shangluo Central Hospital from January 2014 to December 2016 were selected. Enterovirus nucleic acid of patients was detected by real-time fluorescence quantitative polymerase chain reaction. Clinical characteristics of children with HFMD caused by CA6,EV71 and CA16 were analyzed. Results Among 1 528 children with HFMD,374 cases were found infected with CA6,673 cases with CA16 and 481 cases with EV71 through etiological diagnosis. Average onset age（ t value was 6. 34 and 5. 85,respectively） and distribution of herpes in gum（ χ^2 value was 5. 65 and 5. 23,respectively） in CA6 positive cases were lower than those in CA16 and EV71 positive cases（ all P〈0. 05）. Incidence of fever in CA6 positive cases was higher than that in CA16 and EV71 positive cases（ χ^2 value was 8. 56 and 8. 23,respectively,both P〈0. 05）. C-reactive protein and WBC increasing in CA6 positive patients were higher than those in CA16 and EV71 positive cases（ χ^2 value was 5. 34,5. 89,6. 34 and 6. 83,respectively,all P〈0. 05）. Conclusion CA6 has developed into a new type of predominant pathogen in children with HFMD,and HFMD caused by it has clinical characteristics different from those caused by EV71 and CA16,which can be used as a basis for clinical diagnosis.