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目的分析北京市朝阳区部分婴幼儿肠道病毒71型(enterovirus 71,EV71)感染率及手足口病(hand-foot-mouth disease,HFMD)发病情况。方法选择北京市朝阳区小红门、酒仙桥社区6~35月龄健康婴幼儿为观察对象,共采集血清414份,检测中和抗体水平,并采集符合“可疑肠道病毒病”入选标准患者的咽拭子和肛拭子标本,应用RT-PCR法进行其他肠道病毒EV-G、柯萨奇病毒A16型(Coxsackie virus type A16,CA16)、EV71特异性核酸筛查。同时对观察对象进行1年随访,调查HFMD发病情况。将观察对象分为6~11月、12~17月、18~23月、24~29月、30~35月5个月龄组。结果 414名观察对象中,EV71中和抗体阳性39人,阳性率为9.42%,随着月龄的增加,阳性率呈递增趋势(P<0.001);男性婴幼儿EV71中和抗体阳性率为8.90%(17/191),女性为9.87%(22/223),二者差异无统计学意义(P>0.05)。414名观察对象中,29例肠道病毒阳性,其中女性14例,男性15例,男女发病比例为1.07:1;CA16感染率为31.03%(9/29),EV71感染率为17.24%(5/29),其他肠道病毒感染率为51.72%(15/29)。尚不能认为男女性别间肠道病毒感染及EV71和CA16感染的构成比有差别,也不能认为EV71中和抗体情况对肠道病毒感染率和EV71发病率有影响;随着年龄的增长,EV71感染人数呈递增趋势,而CA16则保持不变;小红门社区EV71中和抗体阳性率(12.25%)与酒仙桥社区(4.45%)差异有统计学意义(P<0.05)。结论月龄越大,婴幼儿血清EV71抗体阳性率越高;小红门和酒仙桥地区检测到的HFMD患儿主要病原体为CA16和EV71,且CA16感染率高于EV71感染率。
Objective To analyze the prevalence of enterovirus 71 (EV71) infection and hand-foot-mouth disease (HFMD) in infants and young children in Chaoyang District of Beijing. Methods A total of 414 serum samples were collected from healthy children and young children aged 6 ~ 35 months in Xiaogamen and Jiuxianqiao communities, Chaoyang District, Beijing. The levels of neutralizing antibodies were detected and the data were collected in line with “Suspected Enterovirus Disease” Throat swabs and anal swabs from standard patients were tested for other enterovirus EV-G, Coxsackie virus type A16 (CA16), and EV71 specific nucleic acid using RT-PCR. At the same time observe the object for 1 year follow-up to investigate the incidence of HFMD. Subjects were divided into 6 ~ November, 12 ~ 17 months, 18 ~ 23 months, 24 ~ 29 months, 30 ~ 35 months 5 months age group. Results The positive rate of neutralizing antibody of EV71 was 9.42% in 414 observation subjects. The positive rate of EV71 increased with the increase of age (P <0.001). The positive rate of EV71 neutralizing antibody in male infants was 8.90 % (17/191) women and 9.87% (22/223) women, the difference was not statistically significant (P> 0.05). Of the 414 subjects, 29 were positive for enterovirus, including 14 females and 15 males, with a ratio of 1.07: 1. The prevalence of CA16 infection was 31.03% (9/29), and the EV71 infection rate was 17.24% (5 / 29), other intestinal virus infection rate was 51.72% (15/29). It can not yet be considered that there is a difference between the constituent ratio of enterovirus infection between men and women and the composition of infection with EV71 and CA16 and that the neutralizing antibody of EV71 has no effect on the incidence of enterovirus infection and the incidence of EV71; EV71 infection While the number of CA16 remained the same. The positive rate of EV71 neutralizing antibody in Xiaohongmen community was 12.25% and that in Jiuxianqiao community was 4.45%. There was a significant difference (P <0.05). Conclusion The higher the age, the higher the positive rate of serum EV71 antibody in infants and toddlers. The major pathogens of HFMD detected in Xiaohongmen and Jiuxianqiao are CA16 and EV71, and the infection rate of CA16 is higher than that of EV71.