论文部分内容阅读
目的了解粤东地区2011年婴幼儿手足口病的病原体分型情况及其与临床的关系。方法采集2011年1月至12月汕头大学医学院第二附属医院儿科手足口病住院患儿的咽拭子标本,RT-PCR检测肠道病毒71型(EV71),柯萨奇病毒A组16型(CoxA16),肠道病毒属,并对扩增产物测序鉴定。结果 301例患儿中有214例咽拭子中检测到肠道病毒,病毒阳性率为71.1%,其中EV71 60例,占28.0%,CoxA16 108例,占50.5%,除EV71、CoxA16外的其他型别肠道病毒为46例,占21.5%;91例患儿有明显神经系统损害,其中33例EV71检测阳性(33/60,55.0%),35例CoxA16检测阳性(35/108,32.4%),8例除EV71、CoxA16外其他型别肠道病毒检测阳性(8/46,17.4%),15例肠道病毒检测阴性。除1例由EV71引起的的危重型手足口病死亡外其余300例均痊愈出院。结论粤东地区2011年手足口病病原体主要为CoxA16、EV71,但CoxA16已经成为当年优势病原体,其他型肠道病毒也占有一定比率。而EV71最容易引起神经系统损害和导致重症及危重症,EV71、CoxA16及其他型肠道病毒均可引起神经系统损害。
Objective To understand the pathogen typing of infants with hand-foot-mouth disease in eastern Guangdong in 2011 and its clinical significance. Methods Throat swabs from children hospitalized with pediatric HFMD in the Second Affiliated Hospital of Shantou University Medical College from January to December 2011 were collected. RT-PCR was performed to detect EV71, Coxsackievirus A 16 (CoxA16), enterovirus, and sequencing the amplified products. Results The positive rate of EV71 was 71.1% in 214 throat swabs of 301 children, including 60 EV71 cases (28.0%), CoxA16 108 cases (50.5%), EV71 and CoxA16 46 cases were type enterovirus, accounting for 21.5%; 91 cases had obvious neurological damage, of which 33 cases were positive for EV71 (33 / 60,55.0%) and 35 cases were positive for CoxA16 (35/108, 32.4% ), 8 cases of other types of enterovirus other than EV71, CoxA16 positive (8/46, 17.4%), 15 cases of enterovirus negative. All but one of the 300 deaths from critically ill hand, foot and mouth disease caused by EV71 were cured. Conclusion The pathogens of hand-foot-mouth disease in eastern Guangdong province in 2011 are mainly CoxA16 and EV71, but CoxA16 has become the predominant pathogen in the year and other enteroviruses also occupy a certain proportion. The EV71 most likely to cause nervous system damage and lead to severe and critically ill, EV71, CoxA16 and other enteric viruses can cause nervous system damage.