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目的分析2010-2013年济南市历城区手足口病(HFMD)病例特征和病原学变化。方法病例调查采用面对面方式,病原学检测应用实时荧光定量PCR方法。结果共调查2010-2013年HFMD病例414例,1~5岁儿童占85.99%(356/414),男女性别比为1.59∶1。病例皮疹主要分布在手、口、足、臀等部位,38.89%的病例伴有发热。阳性标本342份,阳性检出率为82.61%。发病后7 d内采样标本阳性检出率显著高于7 d后采样阳性率(84.76%vs 62.50%,χ2=12.46,P<0.001)。不同年份之间病原学构成差异有统计学意义(χ2=39.45,P<0.001)。结论济南市历城区HFMD多发生在1~5岁儿童,近40%的病例伴有发热,优势病原型别为肠道病毒71(EV71)型和柯萨奇病毒A16(CoxA16)型,两者在不同年份之间呈现交替流行的现象,其他肠道病毒在HFMD致病中也扮演着重要角色,值得今后进一步开展研究工作。
Objective To analyze the characteristics and etiological changes of hand foot and mouth disease (HFMD) in Li Cheng District in Jinan City from 2010 to 2013. Methods The case investigation was conducted in face-to-face manner, and the etiological detection was performed by real-time fluorescence quantitative PCR. Results A total of 414 HFMD cases were surveyed in 2010-2013. 85.99% (356/414) of children aged 1 to 5 years were enrolled. The sex ratio was 1.59:1. Cases of rashes mainly in the hands, mouth, feet, buttocks and other parts, 38.89% of cases accompanied by fever. 342 positive samples, the positive detection rate was 82.61%. The positive detection rate of sampling samples within 7 days after onset was significantly higher than that after 7 days (84.76% vs 62.50%, χ2 = 12.46, P <0.001). The etiological composition of different years was statistically significant (χ2 = 39.45, P <0.001). Conclusion HFMD in Li Cheng District of Ji’nan City occurs mostly in children aged 1 to 5 years. Nearly 40% of the cases are accompanied by fever. The dominant pathogens are Enterovirus 71 (EV71) and CoxA16 (CoxA16) Alternating epidemics between years, other enteroviruses also play an important role in the pathogenesis of HFMD and are worth further research in the future.