2010-2018年六安市手足口病病原学特征分析

Analysis of etiological characteristics of hand-foot-mouth disease(HFMD)in Lu’an City from 2010 to 2018

目的分析2010―2018年六安市手足口病病原学特征,为手足口病的防控提供科学依据。方法收集2010―2018年六安市各县区手足口病临床诊断病例咽拭子样本,采用实时荧光定量PCR技术进行肠道病毒核酸检测,并对检测结果进行分析。结果在采集的2360份手足口病临床诊断病例咽拭子样本中,肠道病毒核酸检测阳性的有1085份(45.97%),其中肠道病毒71型(Enterovirus 71,EV71)382份(35.21%),柯萨奇病毒A16型(Coxsackievirus A16,COXA16)334份(30.78%),柯萨奇病毒A6型(Coxsackievirus A6,COXA6)169份(15.58%),柯萨奇病毒A10型(Coxsackievirus A10,COXA10)15份(1.38%),其他肠道病毒185份(17.05%)。2010―2014年及2016年EV71为优势流行株(X^(2)=188.555,P<0.001),2015年和2017年以COXA6成为优势流行株(X^(2)=258.732,P<0.001)。从检测结果看,不同县区阳性率存在统计学差异(X^(2)=68.879,P<0.001),以叶集区最高(81.25%,52/64),霍邱县最低(30.41%,52/171)。1~3岁年龄组患病人数居高,占各年龄组总阳性数的68.11%(739/1085)。1085例阳性病例中男性705例,女性380例,但是阳性检出率无性别差异(X^(2)=1.354,P=0.245)。结论六安市手足口病病原为多型别共存,每年的优势毒株均发生变化,年龄、地域和性别等因素均可影响手足口病的流行,加强手足口病的监测,有利于该病的防控。

Objective The etiogical characteristics of hand-foot-mouth disease(HFMD)in Lu’an City from 2010 to 2018 were analyzed to provide basis for the prevention and control of HFMD.Methods Pharyngeal swabs were collected from clinical-diagnosis-case of HFMD in all counties and districts of Lu’an City from 2010 to 2018.Quantitative real-time PCR was used to detect Enterovirus nucleic acid,and the detection results were analyzed.Results Among the 2360 pharyngeal swabs collected from clinical-diagnosis-case of HFMD,1085(45.97%)were positive from Enterovirus.There were 382(35.21%)of Enterovirus 71(EV71),334(30.78%)of Coxsackievirus A16(COXA16),169(15.58%)of Coxsackievirus A6(COXA6),15(1.38%)of Coxsackievirus A10(COXA10),and 185(17.05%)of other Enteroviruses.EV71 was the dominant strain from 2010 to 2014 and 2016(X^(2)=188.555,P<0.001),and COXA6 was the dominant strain in 2015 and 2017(X^(2)=258.732,P<0.001).The positive rate was significantly different in different counties(X^(2)=68.879,P<0.001),with the highest rate in Yeji District(81.25%,52/64),and the lowest rate in Huoqiu County(30.41%,52/171).The number of patients in 1-3-year-old group was the highest,accounting for 68.11%(739/1085)of the total positive cases in each age group.Among the 1085 positive cases,705 were male and 380 were female,but there was no statistical difference in the positive detection rate(X^(2)=1.354,P=0.245).Conclusions There are various types of HFMD pathogens in Lu’an City,and the dominant strains change every year.Factors such as season,age,region and gender can affect the prevalence of HFMD.Strengthening the monitoring of HFMD pathogen is helpful to prevent and control HFMD.