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目的分析唐山市手足口病病原体分布特征、手足口病重症危险因素,比对不同类型临床标本检出率,为做好手足口病预防和治疗提供科学依据。方法对2009-2011年唐山市手足口病临床诊断病例肛拭子及咽拭子标本进行肠道病毒71型(Human enterovirus 71,EV 71)、柯萨奇病毒A16型(Coxsackie virus A16,Cox A16)及其他肠道病毒(Pan-enterovirus,PE)核酸检测及重症病例危险因素分析。结果 1 286例被检测手足口病病例标本中859例为肠道病毒阳性,阳性率为66.80%(859/1 286)。病原体构成以EV 71病毒感染率最高,占37.37%。肛拭子标本检出率明显高于咽拭子标本检出率,低龄、北部地区和EV 71均为手足口病并发重症病例的危险因素,感染EV 71引发重症是Cox A16和其他肠道病毒的6.3倍和2.9倍。结论 2009-2011年引起唐山市手足口病的主要病原体是EV 71,提高病原体检出率对手足口病的临床治疗、流行病学调查意义重大。
Objective To analyze the distribution characteristics of pathogens of hand-foot-mouth disease and the risk factors of hand-foot-mouth disease in Tangshan City, and to compare the detection rate of different types of clinical specimens so as to provide a scientific basis for the prevention and treatment of hand-foot-mouth disease. Methods The clinical data of anal swabs and throat swabs from 2009 to 2011 in clinically diagnosed cases of hand-foot-mouth disease in Tangshan were tested for the effects of Enterovirus 71 (EV 71), Coxsackie virus A16 (Cox A16 ) And other enterovirus (PE) nucleic acid detection and analysis of risk factors for severe cases. Results A total of 1 286 cases of hand, foot and mouth disease cases were detected in 859 cases of enterovirus positive, the positive rate was 66.80% (859/1 286). The infection rate of EV71 was the highest, accounting for 37.37%. The detection rate of anal swab specimens was significantly higher than the detection rate of throat swab specimens. The younger age, the northern region and EV 71 were both risk factors for hand-foot-mouth disease complicated with severe cases. EV71-induced severe disease was Cox A16 and other enterovirus 6.3 times and 2.9 times. Conclusion The main cause of HFMD in Tangshan in 2009-2011 is EV 71. It is of great significance to improve the detection rate of pathogens in clinical treatment of hand-foot-mouth disease.