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目的分析惠州市2008-2011年手足口病重症病例流行病学特征和病原学特征,为制定手足口病预防控制措施提供科学依据。方法选取惠州市2008-2011年手足口病定点收治医院报告的255例重症病例作为研究对象,采集重症患者发病1周内的咽拭子或肛拭子,用RT-PCR法对患者标本进行总肠道病毒、柯萨奇病毒A组16型(CoxA16)和肠道病毒71型(EV71)的特异性核酸检测。结果 255例重症手足口病病例中,肠道病毒通用型核酸阳性180份,检出率70.59%(180/255),其中EV71、CoxA16、非EV71和CoxA16的其他肠道病毒(other intestinal virus)核酸分别为144、6、30份,占肠道病毒感染阳性的80.0%(144/180)、3.33%(6/180)、16.67%(30/180),非肠道病毒(NEV)75例占29.41%(75/255)。重症病例以5岁以下儿童为主,EV71阳性者中以3岁以下幼童为多,男性多于女性,以散居儿童居多。结论 2008-2011年引起惠州市手足口病重症的病原体以EV71为主,占80%,CoxA16的检出率为3.33%,非EV71和CoxA16其他肠道病毒的检出率为16.67%。EV71是惠州市近四年引起手足口病重症病例的优势流行毒株。RT-PCR可用于手足口病重症病例的快速诊断,对5岁以下儿童手足口病进行病原学检测,及早发现重症病例、及早治疗,是防止手足口病死亡病例的关键。
Objective To analyze the epidemiological and etiological characteristics of HFMD cases in Huizhou from 2008 to 2011 and provide scientific evidence for the development of HFMD prevention and control measures. Methods A total of 255 critically ill cases reported in HFMD from 2008 to 2011 in Huizhou were enrolled in this study. Throat swabs or anal swabs were collected within 1 week of onset of critically ill patients. Enterovirus, Coxsackie A, Type 16 (CoxA16) and Enterovirus 71 (EV71). Results Of the 255 cases of severe HFMD, 180 were positive for enterovirus universal nucleic acid with a detection rate of 70.59% (180/255), among which EV71, CoxA16, other intestinal viruses other than EV71 and CoxA16, The nucleic acids were 144, 6 and 30 respectively, accounting for 80.0% (144/180), 3.33% (6/180), 16.67% (30/180) and 75 (NEV) positive for enterovirus infection Accounting for 29.41% (75/255). Major cases of children under 5 years of age, EV71-positive in children under 3 years of age as more men than women, mostly diaspora. Conclusion The major pathogens causing hand, foot and mouth disease in Huizhou City in 2008-2011 were EV71, 80%, CoxA16, and non-EV71 and CoxA16, respectively. The detection rate of other enteroviruses was 16.67%. EV71 is the most popular epidemic strain of HFMD in Huizhou City in recent four years. RT-PCR can be used for the rapid diagnosis of severe cases of hand-foot-mouth disease. The etiological detection of hand-foot-mouth disease in children under 5 years old, early detection of severe cases and early treatment are the keys to prevent the death of hand-foot-mouth disease.