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目的分析十堰地区手足口病病原谱构成及其动态变化,为该病的预防控制提供参考。方法 2008年5月至2013年12月,从十堰市各县(市、区)收集2076例手足口病临床诊断病例标本,用一步法反转录聚合酶链反应(one-step RT-PCR)和实时荧光定量反转录聚合酶链反应(real-time RT-PCR)法进行手足口病毒核酸检测并分型,结合病例基本信息,对判定为手足口病的确诊病例,采用描述流行病学方法进行病原谱动态分析。结果 2008-2013年,肠道病毒71型(EV71)、柯萨奇病毒A组(Cox A16、Cox A6、Cox A10)及其他型人肠道病毒(EV)在手足口病确诊病例中的病原构成比依次为46.35%(24.19%~62.23%)、38.12%(13.06%~70.97%)、5.99%(0~13.06%)、3.75%(0~8.28%)和5.79%(1.37%~15.12%)。Cox A6与Cox A10致病对象为≤5岁婴幼儿;4-6月出现夏季流行高峰,10-11月出现冬季流行小高峰;各县(市、区)流行的手足口病毒均在4种以上,Cox A6所占比例持续上升,2013年达到13.06%。结论 2008-2013年十堰地区手足口病流行较为严重,病原体包括EV71、Cox A16、Cox A6、Cox A10等多种型别肠道病毒,EV71与Cox A16逐年交替维持着优势地位,Cox A6近2年有持续上升的趋势值得关注。国家在今后的疫情防控、疫苗策略和临床管理中,应高度重视手足口病持续流行过程中病原谱的变化。
Objective To analyze the composition and dynamic changes of HFMD spectrum in Shiyan and to provide reference for the prevention and control of the disease. Methods From May 2008 to December 2013, 2076 cases of hand, foot and mouth disease were collected from all counties (cities and districts) in Shiyan. One-step reverse transcription-polymerase chain reaction (RT-PCR) And real-time RT-PCR method to detect and classify hand-foot-mouth virus nucleic acid. Combined with the basic information of the cases, the diagnosis of hand-foot-mouth disease confirmed by epidemiology Methods The dynamic analysis of pathogen spectrum was performed. Results In 2008-2013, the etiology of enterovirus 71 (EV71), Cox A16 (Cox A6, Cox A10) and other types of human enterovirus (EV) in confirmed cases of HFMD The constituent ratios were 46.35% (24.19% -62.23%), 38.12% (13.06% -70.97%), 5.99% (0-13.8%), 3.75% (0-8.28%) and 5.79% (1.37% -15.12% ). The incidence of Cox A6 and Cox A10 were less than 5 years old infants and young children; the summer peak appeared in April-June and the winter peaked in 10-11 month; the prevalence of hand-foot-and-mouth virus in all counties (cities and districts) As a result, the proportion of Cox A6 continued to rise, reaching 13.06% in 2013. Conclusion The HFMD epidemic in Shiyan area was more serious in 2008-2013. The pathogens included EV71, Cox A16, Cox A6, Cox A10 and other types of enterovirus. EV71 and Cox A16 maintained their predominant position year after year. Cox A6 was nearly 2 There is a growing trend of concern. In the future epidemic prevention and control, vaccine strategies and clinical management, the state should attach great importance to the changes of pathogenic spectrum during the continuous epidemic of HFMD.