2015-2017年惠州市重症手足口病病原学分析

Pathogen analysis of severe hand-foot-mouth disease in Huizhou from 2015 to 2017

目的分析惠州市重症手足口病病原学特点,为手足口病的预防和诊治提供科学依据。方法以2015年1月到2017年12月间惠州市儿童医院收治的2 055例重症手足口病住院病例为研究对象,采集患儿肛拭子标本,提取肠道病毒RNA,利用实时荧光定量PCR方法检测肠道病毒核酸,结合临床资料,采用SPSS20.0软件进行病原学分析。结果 2015-2017年共检测2 055例重症手足口病病例,肠道病毒核酸阳性1 699例,其中EV71、CA16和other EVs分别检出349、117和1 233例,其构成比分别为20.54%、6.89%和72.57%。2017年CA6和CA10各检出406例和119例,构成比分别为56.31%和16.51%。EV71、CA16和other EVs引起重症手足口病的重症率分别为77.21%、50.65%和64.96%。重症手足口病患儿中,10月龄以下占10.59%、10月龄~组占74.93%、3~岁组占11.54%和5岁以上占2.94%。结论 2015-2017年引起重症手足口病的主要病原体为other EVs,引起手足口病重症率最高的病原体为EV71,10月龄~儿童是重症手足口病主要发病人群。

Objective To analyze the etiological features of severe hand-foot-mouth disease(HFMD)in Huizhou to provide scientific basis for the targeted prevention and treatment of HFMD.Methods A total of 2 055 patients with severe HFMD admitted to in Huizhou Children.s Hospital from January 2015 to December 2017 were selected as study subjects.The anal swabs of the children were collected and the enterovirus RNA was extracted.The enterovirus nucleic acid was detected by Real-time fluorescence quantitative PCR.Combined with clinical data,SPSS software was used to analyze the etiology.Results From 2015 to 2017,a total of 2 055 cases of severe hand foot and mouth disease were detected,and 1 699 cases were positive for enterovirus nucleic acid.Among them,EV71,CA16 and other EVs were detected in 349,117 and 1 233 cases,respectively,with a composition ratio of 20.54%,6.89%and 72.57%,respectively.In 2017,406 cases of CA6 and119 cases of CA10 were detected,with the constitutive ratios of 56.31%and 16.51%,respectively.The rates of severe HFMD caused by EV71,CA16 and other EVs were 77.21%,50.65%and 64.96%,respectively.Among the patients with severe HFMD,below 10 months old was 10.59%;10 months to 3 years old was 74.93%;3 to 5 years old was 11.54%and above 5 years old was 2.94%.Conclusion Other EVs was the major pathogen that caused severe HFMD in Huizhou during2015-2017;the severe rate of HFMD caused by EV71 was the highest,and the children aged 10 months to 3 years old were the main population of severe HFMD.