上海奉贤地区手足口病患者并发甲损害相关因素分析

A study on the related factors of nail changes in hand-foot-mouth disease in Fengxian District of Shanghai

目的研究上海奉贤地区手足口病患者并发甲损害的临床特点及相关因素。方法收集580例手足口病患者,详细记录一般情况、临床症状、皮损特点,应用实时荧光定量聚合酶链反应(PCR)对患者咽拭子标本进行病毒核酸检测。通过随访,调查手足口病后甲损害情况。结果手足口病后的甲损害主要表现为甲Beau’s线和(或)甲脱落,发生率为12.36%(68/550),其中表现为Beau’s线者占26.47%(18例),甲脱落者占29.41%(20例),同时有Beau’s线和甲脱落者占44.12%(30例),有甲损害和无甲损害的两组患者在性别、年龄、是否发热、病程、甲周是否有皮损、用药方面差异无统计学意义;在病毒型别方面的差异存在统计学意义,感染柯萨奇病毒A6型(CV-A6)脱甲发生率最高(36.22%)。结论甲Beau’s线和(或)甲脱落可能是手足口病的后期并发症,CV-A6为主要病原。

Objective To investigate the clinical characteristics and related factors of nail changes in hand-foot-mouth disease(HFMD)in Fengxian District of Shanghai.Methods 580 HFMD patients whose general conditions,clinical symptoms,and skin lesions were recorded in detail,were followed up for delayed nail manifestations.The nucleic acids of enterovirus were determined by real-time fluorescence quantitative PCR of throat swabs from the patients.Results The late-onset nail changes of HFMD were mainly manifested as Beau’s line and/or onychomadesis.The incidence of Beau’s line and/or onychomadesis was 12.36%(68/550):18 cases(26.47%)showed Beau’s line,30 cases(44.12%)showed Beau’s line and onychomadesis,20 cases(29.41%)showed onychomadesis.There were no statistically significant differences in gender,age distribution,geographical distribution,fever,duration of disease,skin lesions and medication between the patients with or without nail changes.There was statistically significant difference in types of virus,in which the incidence rate of onychomadesis in the HFMD caused by CV-A6 was the highest(67.6%).Conclusion Beau’s line and/or onychomadesis might be the delayed complications of HFMD,and CV-A6 is the main pathogen.