2019—2021年铜仁市手足口病原构成及柯萨奇病毒A6临床特征调查研究

Investigation and Research on the Pathogen Composition of Hand,Foot and Mouth and the Clinical Characteristics of Coxsackievirus A6 in Tongren City from 2019 to 2021

目的对2019—2021年铜仁市手足口病原构成进行分析,并对其中分离的柯萨奇病毒A6进行临床特征研究。方法选择在2019年1月—2021年11月来贵州省铜仁市人民医院儿科就诊的患儿,共检出手足口病病毒阳性标本4330例,采用Real-time RT-PCR法检测病原类型,并对比柯萨奇病毒A62019—2021年临床特征。结果2019—2021年手足口病柯萨奇A6病原体检出率最高(2019年:30.86%;2020年23.30%;2021年29.91%),肠道病毒71型(Human enterovirus 71,EV71)病原体检出率最低(2019年:0.13%;2020年1.38%;2021年0.46%);2019—2021年以柯萨奇病毒A6为病原体的手足口病患者,发热症状人数(2019年:289例;2020年135例;2021年90例)占比最多,白细胞升高(2019年:98例;2020年43例;2021年13例)和C反应蛋白(2019年:102例;2020年57例;2021年21例)升高症状人数占比相对较少。结论除未分型病例外,柯萨奇A6病原体检出率最高,不同时间段下柯萨奇病毒A6所致手足口病临床表现以发热症状最为明显。

Objective To analyze the composition of hand,foot and mouth pathogens in Tongren City from 2019 to 2021,and the clinical characteristics of the isolated coxsackievirus A6.Methods A total of 4330 cases of HFMD virus positive specimens were detected in children who came to the Pediatrics Department of Tongren People's Hospital of Guizhou Province from January 2019 to November 2021.Real-time RT-PCR method was used to detect the type of pathogen,and the clinical characteristics of Coxsackievirus A6 from 2019 to 2021 were compared.Results The detection rate of HFMD Coxsackie A6 pathogen was the highest from 2019 to 2021(2019:30.86%;2020:23.30%;2021:29.91%).Enterovirus 71(EV71)had the lowest pathogen detection rate(2019:0.13%;2020:1.38%;2021:0.46%).From 2019 to 2021,the number of HFMD patients with coxsackie virus A6 as the pathogen accounted for the largest number of patients with fever symptoms(2019:289 cases;2020:135 cases;2021:90 cases).The proportion of patients with elevated white blood cells(2019:98cases;2020:43cases;2021:13cases)and C-reactive protein(2019:102cases;2020:57cases;2021:21cases)was relatively low.Conclusion Except for untyped cases,the pathogen detection rate of Coxsackie A6 is the highest.The clinical manifestations of hand,foot and mouth disease caused by Coxsackie virus A6 in different time periods are the most obvious symptoms of fever.