惠州市2016-2018年手足口病流行病学及病原学变化分析

Analysis of the epidemiological and etiological changes of hand,foot and mouth disease in Huizhou from 2016 to 2018

目的了解2016-2018年惠州市手足口病流行病学及病原学变化并进行分析。方法选取2016年1月至2018年12月"全国传染病信息报告管理系统"报告的惠州市手足口病例和本院实验室诊断病例,PCR技术进行病原学分析,并对重症手足口病进行临床特征分析[白细胞、中性粒细胞、C反应蛋白(CRP)、降钙素原(PCT)、血糖、乳酸、住院时间、住院费用、氨基末端B型钠尿肽前体(NT-proBNP)、IgG、IgA、IgM]。结果2016-2018年手足口病病原学分析,肠道病毒71型(EV71)、柯萨奇病毒A组16(CVA16)占比显著下降,CVA6及其他肠道病毒占比显著上升,2017-2018年,CVA6及其他肠道病毒成为惠州市手足口病的优势致病病毒株,差异有统计学意义(P<0.05)。重症手足口病EV71组在白细胞、中性粒细胞、CRP、PCT、血糖、乳酸、住院时间、住院费用方面均显著高于非EV71组(P<0.05)。结论CVA6及其他肠道病毒成为惠州市手足口病的优势致病病毒株,EV71感染的重症手足口病在病情严重度、消耗医疗资源等方面比其他肠道病毒显著增大。

Objective To understand and analyze the epidemiological and etiological changes of hand,foot and mouth disease in Huizhou from 2016 to 2018.Methods From January 2016 to December 2018,the laboratory diagnostic cases of hand,foot and mouth diseases in Huizhou in our hospital reported to National Infectious Disease Information Reporting Management System were included.The pathogens were analyzed by PCR technology.The clinical characteristics,including white blood cells,neutrophils,CRP,PCT,blood sugar,lactic acid,hospital stay,expenses,NT-proBNP,IgG,IgA,IgM,of severe hand,foot and mouth disease were analyzed.Results From 2016 to 2018,the proportion of EV71 and CVA16 significantly decreased,while the proportion of CVA6 and other enteroviruses significantly increased.CVA6 and other enteroviruses became the dominant pathogenic strains of hand,foot and mouth disease in Huizhou(P<0.05),with statistical significance.The leucocytes,neutrophils,CRP,PCT,blood sugar,lactic acid,hospitalization days and hospitalization expenses of severe EV71 group were significantly higher than those of non-EV71 group(P<0.05).Conclusion CVA6 and other enteroviruses have become the predominant pathogenic strains of hand,foot and mouth disease in Huizhou.Severe hand,foot and mouth disease infected by EV71 is more serious and consumes more medical resources than the other enteroviruses.