论文部分内容阅读
目的:人肠道病毒71型(human Enterovirus 71,EV71)和科萨奇病毒A组16型(Coxsackievirus A16,Cox A16)是引起手足口病的主要病毒病原,本文比较了两种病毒致手足口病的主要临床表现及其预后。方法:收集2011年1月至6月南京医科大学附属南京市儿童医院手足口病患者共570例的临床资料及咽拭子标本,采用实时荧光探针PCR法检测患者的咽拭子标本的病毒类型,比较EV71和CoxA16两种病毒引起的手足口病的主要临床表现及其预后。结果:350例EV71感染患者平均年龄(2.5±1.7)岁,220例Cox A16感染患者平均年龄(2.3±1.3)岁。EV71感染患者的住院时间长(P<0.01);发热超过39℃且持续时间长(P<0.001);肌阵挛性反射、口腔溃疡都明显偏高(P<0.05);咳嗽、热性惊厥明显偏低(P<0.05);嗜睡等中枢神经系统感染的临床表现明显偏高(P<0.05),其中EV71感染患儿经治疗后有3.7%留有四肢肌力下降等后遗症,并有5例死于心肺衰竭;CoxA16感染的患者经过治疗后都治愈且没有留下后遗症。结论:南京地区2011年1月到6月引起的手足口病病毒以EV71为主。相对于Cox A16,EV71引起的临床表现严重、预后差。
OBJECTIVE: Human Enterovirus 71 (EV71) and Coxsackievirus A16 (Cox A16) are the major viral pathogens that cause HFMD. In this paper, we compared the effects of two viruses on hand, foot and mouth The main clinical manifestations and prognosis of the disease. Methods: Clinical data and throat swabs were collected from 570 patients with hand-foot-mouth disease in Nanjing Children’s Hospital Affiliated to Nanjing Medical University from January to June 2011. Real-time fluorescence PCR was used to detect the throat swab specimens Type, to compare the main clinical manifestations and prognosis of HFMD caused by EV71 and CoxA16 viruses. Results: The mean age of patients with EV71 infection was (2.5 ± 1.7) years and that of 220 patients with Cox A16 infection was (2.3 ± 1.3) years. Patients with EV71 infection had longer hospital stay (P <0.01), fever over 39 ° C and longer duration (P <0.001), myoclonic reflexes and mouth ulcers were significantly higher (P <0.05), cough, febrile seizures (P <0.05). The clinical manifestations of central nervous system infection, such as lethargy, were significantly higher (P <0.05). Among them, 3.7% of children with EV71 infection had sequelae of decreased limb muscle strength and 5 Cases died of heart and lung failure; CoxA16-infected patients were cured after treatment and left no sequelae. Conclusion: The EV71 virus is the main cause of HFMD in Nanjing from January to June in 2011. Relative to Cox A16, EV71 caused serious clinical manifestations, the prognosis is poor.