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目的分析2013至2015年北京大学北京地坛医院教学医院手足口病住院患者的病原体类型及分布特点,为手足口病的诊疗及预防提供关键性的指导。方法收集2015年北京大学北京地坛医院教学医院儿科收治的手足口病住院患者共84例的咽拭子及粪便标本,提取病毒RNA,采用实时荧光聚合酶链反应(real time-PCR)法,进行肠道病毒(EV)通用型、肠道病毒71(EV71)型及柯萨奇A16(Cox A16)型肠道病毒核酸检测,并与2013年和2014年度本院手足口病病原学结果进行对比分析。结果 2015年手足口病患者的EV阳性率为86.9%(73/84),其中EV71型肠道病毒占44.05%(37/84),非EV71非Cox A16型肠道病毒占40.48%(34/84),Cox A16型肠道病毒占2.38%(2/84)。与2013年相比,2015年非EV71非Cox A16型肠道病毒感染率显著下降(χ~2=10.20、P=0.001),差异具有显著统计学意义,而EV71型感染率显著升高(χ~2=28.38、P<0.001),差异具有极显著统计学意义;与2014年相比,2015年非EV71非Cox A16型肠道病毒感染率显著升高(χ~2=15.50、P<0.001),差异均具有极显著统计学意义;EV71型感染率有所下降,但差异无统计学意义(χ~2=1.89、P=0.019)。结论 2013至2015年手足口病病原学分布变化较大,2013年本院手足口病患者以非EV71非Cox A16型肠道病毒感染为主;2014年以EV71型肠道病毒感染为主;2015年以EV71型和非EV71非Cox A16型肠道病毒感染为主,在未来的手足口病防控中应在重视EV71型肠道病毒感染的同时,重视非EV71非CoxA16型肠道病毒感染。
Objective To analyze the pathogen types and distribution characteristics of HFMD inpatients in Peking University Beijing Ditan Hospital from 2013 to 2015 so as to provide key guidance for the diagnosis and treatment of HFMD. Methods A total of 84 throat swabs and stool specimens of HFMD inpatients admitted to Pediatric Dentistry Hospital of Beijing Ditan Hospital from Peking University in 2015 were collected and viral RNA was extracted. Real-time PCR was performed Enterovirus (EV), enterovirus 71 (EV71) and Cox A16 type enterovirus nucleic acid and compared with the etiology of HFMD in 2013 and 2014 in our hospital analysis. Results The EV positive rate was 86.9% (73/84) in 2015 in HFMD patients, including 44.05% (37/84) in EV71 and 40.48% (40.48%) in non-EV71 non-Cox A16 enterovirus 84), Cox type A16 enterovirus accounted for 2.38% (2/84). Compared with 2013, the non-EV71 non-Cox A16 enterovirus infection rate was significantly decreased (χ ~ 2 = 10.20, P = 0.001), the difference was statistically significant, while the EV71 infection rate was significantly increased (χ ~ 2 = 28.38, P <0.001), and the difference was statistically significant. Compared with 2014, the non-EV71 non-Cox A16 enterovirus infection rate was significantly increased (χ ~ 2 = 15.50, P <0.001) ), The difference was statistically significant. The infection rate of EV71 was decreased, but the difference was not statistically significant (χ ~ 2 = 1.89, P = 0.019). Conclusion The distribution of hand-foot-mouth disease varies greatly between 2013 and 2015. In 2013, HFMD non-EV71 non-Cox-A16 enterovirus was the most common type of HFMD in our hospital in 2013; Year with EV71 type and non-EV71 non-Cox type A16 enterovirus infection in the future prevention and control of HFMD should pay attention to EV71 type enterovirus infection, while non-EV71 non-CoxA16 type enterovirus infection.