手足口病患者肠道病毒感染特征分析

Investigation of intestinal virus infection in patients with HFMD

目的调查手足口病患者肠道病毒感染情况,指导临床疾病预防和控制。方法收集183例手足口病患儿临床资料及标本,样本经前处理后提取RNA,采用荧光PCR试剂盒检测EV71、CA16以及其他肠道病毒,并对结果进行统计学分析。结果 2016年确诊的183例手足口病患儿中,肠道病毒阳性86例,其中EV71感染46例(占53.49%),CA16感染27例(占31.40%),其他肠道病毒感染13例(占15.12%);0~岁组51例(占59.30%),1~岁组13例(占15.12%),3~岁组22例(占25.58%),0~岁组与其他组相比,差异有统计学意义(χ2=5.9535,P=0.0147)。男性患儿57例(占66.28%),女性患儿29例(占33.72%),男、女性差异有统计学意义(χ2=18.2326,P=0.0000)。57例肠道病毒感染手足口病男性患儿中,EV71感染33例,CA16感染16例,其他肠道病毒感染8例;29例女性患儿中,EV71感染13例,CA16感染11例,其他肠道病毒感染5例。春季感染患者31例(36.05%),夏季感染患者17例(19.77%),秋季感染患者14例(16.28%),冬季感染患者13例(27.91%),差异有统计学意义(χ2=13.3953,P=0.0003)。手足口病发热、手部皮疹、足疹、口腔疱疹、住院患者各73例(84.88%)、65例(75.58%)、62例(72.09%)、54例(62.79%)、17例(19.77%),平均住院时间5d。结论手足口病患儿肠道病毒感染类型以EV71为主,以0~岁、男性患儿多发,且以春季为发病高峰期,主要临床表现有发热、皮疹等。

Objective The prevalence of intestinal viruses in patients with HFMD was investigated to guide the clinical prevention and control of diseases. Methods Clinical data on and samples from 183 pediatric patients with HFMD were collected,and RNA was extracted from the samples after pretreatment.A fluorescence PCR kit was used to detect EV71,CA16,and other intestinal viruses.The results were statistically analyzed. Results Of 183 pediatric patients with HFMD in 2016,86 tested positive for an intestinal virus,including 46（53.49%）infected with EV71,27（31.40%）infected with CA16,and 13（15.12%）infected with some other intestinal virus.Fifty-one patients（59.30%）were 0 to 1 year of age,13（15.12%）were 1-3 years of age,and 22（25.58%）were over the age of 3.The rate of infection differed significantly in patients 0-1 year of age and patients in other age groups（χ2=5.9535,P=0.0147）.Fifty-seven pediatric patients（66.28%）were males and 29（33.72%）were females.The rate of infection differed significantly by sex（χ2=18.2326,P=0.0000）.Of 57 male pediatric patients with HFMD due to an intestinal virus,33 were infected with EV71,16 were infected with CA16,and 8 were infected with some other intestinal virus.Of 29 female pediatric patients,13 were infected with EV71,11 were infected with CA16,and 5 were infected with some other intestinal virus.Thirty-one patients（36.05%）were infected in the spring,17（19.77%）were infected in the summer,14（16.28%）were infected in the autumn,and 13（27.91%）were infected in the winter.The number of patients infected each season differed significantly（χ2=13.3953,P=0.0003）.Of patients with HFMD,73（84.88%）had a fever,65（75.58%）had a hand rash,62（72.09%）had a foot rash,54（62.79%）had herpes,and 17（19.77%）were hospitalized.The average duration of hospitalization was 5 d. Conclusion The type of enterovirus infecting pediatric patients with HFMD was mainly EV71,and male pediatric patients with 0-1 year of age were a high-risk group.Incidence peaked in the spring,and the main clinical manifestations included a fever and a rash.