手足口病引起甲脱落的病毒确定研究

Study on the Type of Virus of Onycholysis Caused by Hand-Foot-Mouth Disease

目的研究肠道病毒与脱甲之间的关系,确定手足口病引起甲脱落的病毒。方法研究对象选取2017年3月—2018年6月东莞市万江医院收治的400例手足口病患者和40例脱甲症患者。所有患者先进行EV71、CoxA6、CoxA9、CoxA16-IgM抗体检测,另外手足口病患者治愈后院外追踪、随访甲脱落情况,脱甲症患者追溯手足口病病史情况。分析所有患者EV71、CoxA6、CoxA9、CoxA16-IgM抗体检测结果、手足口病患者的脱甲情况及脱甲症患者手足口病病史。结果手足口病患者中共有45名出现典型脱甲症状,脱甲罹患率为11. 25%;脱甲症患者中33名有手足口病病史,占82. 51%。手足口病患者中各病毒占比为EV71 26. 50%、CoxA6 11. 50%、CoxA9 6. 00%、CoxA16 24. 75%、其他病毒26. 25%,其中未出现脱甲的患者EV71、CoxA16、CoxA6占比最高,依次为27. 89%、25. 63%、8. 16%;出现脱甲的患者中CoxA6、CoxA16、EV71占比最高,依次为37. 78%、17. 78%、15. 55%,二者差异有统计学意义(P <0. 05);脱甲症患者中具有手足口病病史的患者CoxA6、CoxA16、EV71比例分别为18. 18%、15. 15%、12. 12%。结论 CoxA6是手足口病引起甲脱落的主要病毒,另外EV71、CoxA16等也可以引起脱甲。

Objective To study the relationship between enterovirus and demethylation,and to determine the type of virus caused by hand-foot-mouth disease.Methods Selecting400patients with hand-foot-mouth disease and40patients with thyrotoxicosis treated in the hospital from March,2017to June,2018.All patients were tested for EV71,CoxA6,CoxA9and CoxA16-IgM antibodies.Patients with hand-foot-mouth disease were treated after hospitalization.In patients with thyrotoxicosis,the history of hand-foot-mouth disease was traced.EV71,CoxA6,CoxA9,CoxA16-IgM antibody test results,hand-foot-mouth disease in patients with demethylation and deprophylaxis in patients with hand-foot-mouth disease history were analyzed.Results A total of45patients with hand-foot-mouth disease had typical symptoms of nail-removal,with a prevalence of11.25%,and33patients with deafness had a history of hand-foot-mouth disease,accounting for82.51%.The proportion of each type of virus in patients with hand-foot-mouth disease was EV7126.50%,CoxA611.50%,CoxA96.00%,CoxA1624.75%,and other viruses26.25%,among which EV71,CoxA16and CoxA6accounted for the highest proportion of patients without deprophylaxis,followed by27.89%,25.63%,and8.16%;CoxA6,CoxA16and EV71accounted for the highest proportion in patients with demethylation,followed by37.78%,17.78%and15.55%,with significant differences(P<0.05);In patients with a history of hand-foot-and-mouth disease,CoxA6,CoxA16and EV71were18.18%,15.15%and12.12%,respectively.Conclusion CoxA6is the main virus causing the exfoliation of hand-foot-mouth disease.In addition,EV71,CoxA16,etc.can also cause demethylation.