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目的通过了解2010—2015年四川省自贡市手足口病(HFMD)流行病学特征和流行趋势,了解HFMD主要感染原,为临床医生对患者初步诊断及相关单位的有效防控提供参考。方法分析2010—2015年国家疾病监测信息报告管理系统和哨点医院信息系统中患者数据。采集病例咽拭子标本,利用实时荧光定量反转录—聚合酶链式反应方法对病例咽拭子进行核酸检测和型别鉴定。结果 2010—2015年自贡市累计报告病例6 319例,平均发病率38.32/10万。男性发病3 925例,女性2 394例,性别间差异有统计学意义(χ~2=375.14,P<0.01)。以散居儿童和幼托儿童分别占65.83%和30.80%。采集咽拭子标本共837例,检出阳性病例314例,阳性率为37.51%;其中人肠道病毒71型(EV71)阳性率为17.83%,柯萨奇A16病毒(CoxA16)阳性率为30.89%,其他肠道病毒阳性率为51.27%;对2015年7—12月某医院报告39例住院病例进行病原学分析,EV71感染率46.15%(18/39),表现水疱主要分布在手、足、口腔黏膜,常伴随发热(>38.5℃),部分患者出现口腔疼痛、流涎及咽部充血等症状。结论 2010—2015年自贡市主要由EV71和CoxA16引起,病原复杂,应针对不同年龄段患者表现不同症状进行初步筛选,以期患者得到及时有效救治。
Objective To understand the epidemiological characteristics and epidemic trend of HFMD in Zigong City of Sichuan Province from 2010 to 2015 so as to understand the major infectious origin of HFMD and provide reference for clinicians in the initial diagnosis and effective prevention and control of related units. Methods The data of patients in the national disease surveillance information report management system and sentinel hospital information system from 2010 to 2015 were analyzed. Samples of throat swabs were collected and nucleic acid detection and type identification of throat swabs were performed by real-time fluorescence quantitative reverse transcription-polymerase chain reaction. Results A total of 6 319 cases were reported in Zigong City from 2010 to 2015, with an average incidence of 38.32 / 100 000. There were 3 925 males and 2 394 females, with significant differences between sexes (χ ~ 2 = 375.14, P <0.01). The proportion of scattered children and childcare children accounted for 65.83% and 30.80% respectively. A total of 837 samples of throat swabs were collected and 314 positive cases were detected, the positive rate was 37.51%. The positive rate of EV71 was 17.83%, the positive rate of CoxA16 was 30.89 %, And the positive rate of other enterovirus was 51.27%. Etiological analysis of 39 hospitalized cases reported by a hospital from July to December in 2015 showed an EV71 infection rate of 46.15% (18/39), which showed that the blisters were mainly distributed in the hands and feet , Oral mucosa, often accompanied by fever (> 38.5 ℃), some patients with oral pain, salivation and throat congestion and other symptoms. Conclusion From 2010 to 2015, Zigong City is mainly caused by EV71 and CoxA16. The pathogens are complex and should be screened for different symptoms in different age groups in order to get timely and effective treatment.