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目的:分析近3年九江地区引发手足口病病原变化和相应临床特点,指导该地区手足口病的防护,并能为国内手足口病的预防及病原学的变化提供临床数据。方法:采用回顾性分析方法,对2011年至2013年度我院收治的手足口病患儿的性别、年龄、发病时间、居住地、接触史、临床表现、辅助检查、病原学结果和临床转归等进行综合分析。病原学通过咽拭子RT-PCR方法分析。结果:4 222例手足口病患者年龄分布在4个月~11岁。1~5岁患儿占该病发病人数占94.5%,城郊及农村病例多于市区,占61.5%。普通型病例主要表现为手、足、口皮疹(88.7%),发热(73.3%),心肌酶升高(78.5%);重症病例达419例,主要表现为神经系统、循环系统并发症,该类患儿年龄多在1~3岁,常伴有外周血白细胞、中性粒细胞增高等现象,重症病例的病原检测结果肠道病毒71型占77.1%,柯萨奇病毒A16型占15.5%,其它类型肠道病毒感染占7.4%。结论:手足口病已成为幼儿常发病,高发人群为1~5岁的儿童,城郊及农村仍是该病防治的重点区域;手足口病导致神经和循环系统并发症是危害患儿的主要并发症;重症、危重症病例主要见于EV71感染,但是随着其他肠道病毒感染数量的增加,危重症手足口病的比率将会上升;各年度病原学变化有待进一步长期监测。
OBJECTIVE: To analyze the pathogenic changes and clinical features of hand-foot-mouth disease in Jiujiang area in recent 3 years to guide the protection of hand-foot-mouth disease in this area and to provide clinical data for the prevention and pathogenic changes of hand-foot-mouth disease in China. Methods: A retrospective analysis was conducted on the gender, age, onset time, place of residence, exposure history, clinical manifestations, laboratory tests, etiological findings and clinical outcomes of children with hand-foot-mouth disease admitted to our hospital from 2011 to 2013 Such as a comprehensive analysis. Etiology was analyzed by throat swab RT-PCR. Results: The age distribution of 4 222 hand-foot-mouth disease patients ranged from 4 months to 11 years. Children aged 1 to 5 accounted for 94.5% of the total number of cases, and suburbs and rural areas accounted for 61.5% of the cases. The common type of cases were mainly hand, foot and mouth rashes (88.7%), fever (73.3%) and myocardial enzymes (78.5%). The number of severe cases was 419, which mainly manifested as nervous system and circulatory complications. Children aged more than 1 to 3 years old, often accompanied by peripheral leukocytes, neutrophils increased the phenomenon of severe cases of pathogen detection results of enterovirus 71 accounted for 77.1%, Coxsackie virus A16 accounted for 15.5% , Other types of enterovirus infections accounted for 7.4%. Conclusion: Hand, foot and mouth disease has become a common disease in infants. High incidence population is 1 to 5 years old. Outskirts and rural areas are still the key areas for the prevention and treatment of this disease. Hand, foot and mouth disease causes complications of nerve and circulatory system, Severe and critically ill cases are mainly seen in EV71 infection, but as the number of other enteroviral infections increases, the rate of critically ill hand-foot-mouth disease will increase; and the etiological changes in each year need to be monitored for further long-term monitoring.