感染CoxA16与EV71型手足口病的临床特点及流行特征对比

Comparison of Clinical and Epidemiological Features of Hand-foot-mouth Disease Infected withCoxA16 and EV71

目的:探讨感染肠道病毒71型(EV71)、柯萨奇病毒16型(CoxA16)手足口病的临床特点及流行特征,为手足口病治疗提供依据。方法:选取2015年4月-2017年11月本院收治的手足口病患者80例。根据粪便样本结果分为CoxA16组(n=56)和EV71组(n=24)。比较两组临床特点(发热天数、最高体温、心率、流涎、咳嗽、呕吐、腹泻、嗜睡、肌震颤、易惊、出疹部位、脑膜脑炎)、生化指标水平(WBC、IgA、IgG、IgM)、流行特征(发病年龄、地区分布及时间分布)。结果:两组发热天数、最高体温、心率、流涎、咳嗽、呕吐、足底部及臀部出疹发生率比较,差异均无统计学意义(P>0.05);CoxA16组腹泻、肌震颤、易惊发生率均高于EV71组,嗜睡、手掌心出疹、脑膜脑炎发生率均低于EV71组,比较差异均有统计学意义(P<0.05);两组WBC、IgA、IgG和IgM水平比较,差异均无统计学意义(P>0.05);两组发病年龄段与发病地区分布比较,差异均无统计学意义(P>0.05);EV71组发病多发生在4～9月份,且发病率高于CoxA16组(P<0.05)。结论:感染CoxA16与EV71手足口病的年龄段及地区分布特征基本相同,但是临床特点及发病时间分布存在明显差异,而WBC、IgA、IgG、IgM对于感染肠道病毒CoxA16与EV71手足口病的区分、鉴别无明显意义。

Objective:To investigate the clinical and epidemiological characteristics of hand-footmouth disease infected with enterovirus 71(EV71)and coxsackievirus 16(CoxA16),and to provide evidence for the treatment of hand-foot-mouth disease.Method:A total of 80 patients with hand-foot-mouth disease from April 2015 to November 2017 in our hospital were selected.According to the results of fecal samples,they were divided into CoxA16 group(n=56)and EV71 group(n=24).The clinical characteristics(fever days,maximum body temperature,heart rate,salivation,cough,vomiting,diarrhea,lethargy,muscle tremor,susceptibility to convulsion,rash site,meningoencephalitis),biochemical index levels(WBC,IgA,IgG,IgM),epidemic characteristics(age of onset,regional distribution and time distribution of onset)between the two groups were compared.Result:The fever days,maximum body temperature,heart rate,and incidence of salivation,cough,vomiting,rash on the sole and buttocks of the two groups were compared,the differences were not statistically significant(P>0.05).The incidence of diarrhea,muscle tremor and susceptibility to convulsion in CoxA16 group were higher than those of EV71 group,the incidence of sleepiness,palm rash and meningoencephalitis in EV71 group were lower than those of EV71 group,the differences were statistically significant(P<0.05).The levels of WBC,IgA,IgG,IgM in two groups were compared,the differences were not statistically significant(P>0.05).The age of onset and regional distribution in two groups were compared,the differences were not statistically significant(P>0.05),the incidence of EV71 group was mainly from April to September,and the incidence of disease in EV71 group was higher than that of CoxA16 group(P<0.05).Conclusion:Hand-foot-mouth disease infected with EV71 and CoxA16 have the same age and regional distribution characteristics,but there are obvious differences in clinical characteristics and time distribution of onset,however,WBC,IgA,IgG and IgM have no significant significance in differentiating handfoot-mouth disease infected with enterovirus CoxA16 and EV71.