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目的分析永州市2012年1-12月手足口病(HFMD)的病原学特征,为手足口病的预防控制工作提供病原学依据。方法选取2012年1-12月辖区内三级甲等综合性医院定点收治的278例手足口病病例作为研究对象。采集HFMD患儿发病1周内的咽拭子标本,用实时荧光RT-PCR法对患者进行总肠道病毒、柯萨奇病毒A组16型(CoxA16)和肠道病毒71型(EV71)的特异性核酸检测。回顾性分析患儿性别、年龄、病例来源的分布情况。结果 278例手足口病病例中,肠道病毒通用型核酸阳性182份,检出率65.47%(182/278),其中EV71、CoxA16、EV71和CoxA16混合感染、非EV71和CoxA16的其他肠道病毒核酸分别为151、1、1、29份,占肠道病毒感染阳性的82.97%(151/182)、0.55%(1/182)、0.55%(1/182)、15.93%(29/182),非肠道病毒(NEV)96例占34.53%(96/278)。患儿以3岁以下儿童为主,男性多于女性,以散居儿童居多。结论 2012年1-12月永州市HFMD流行的病原体优势株可能为EV71,实时荧光RT-PCR可用于手足口病的快速诊断,对3岁以下儿童手足口病进行病原学检测,及早发现及早治疗,是防止手足口病死亡病例的关键。
Objective To analyze the etiological characteristics of hand-foot-mouth disease (HFMD) from January 2012 to December 2012 in Yongzhou City and provide etiological evidence for the prevention and control of hand-foot-mouth disease. Methods A total of 278 cases of hand-foot-mouth disease (STD-FMD) were selected from Grade A general hospitals in the area from January to December in 2012 as the research object. Throat swab specimens from children with HFMD within 1 week of onset were collected for total enterovirus, Coxsackie A, type 16 (CoxA16) and enterovirus 71 (EV71) by real-time fluorescence RT- Specific nucleic acid detection. Retrospective analysis of children with gender, age, distribution of the source of cases. Results Among the 278 cases of HFMD, 182 were positive for enterovirus DNA, with a detection rate of 65.47% (182/278), among which EV71, CoxA16, EV71 and CoxA16 were mixed with other enteroviruses not EV71 and CoxA16 The numbers of nucleic acids were 151,1,1,29, accounting for 82.97% (151/182), 0.55% (1/182), 0.55% (1/182) and 15.93% (29/182), respectively, , 96 cases of non-enterovirus (NEV) accounted for 34.53% (96/278). Children under 3 years of age dominated, more men than women, mostly diaspora. Conclusion The predominant pathogens of HFMD epidemic in Yongzhou from January to December in 2012 may be EV71. Real-time fluorescence RT-PCR can be used for the rapid diagnosis of hand-foot-mouth disease and pathogen detection of hand-foot-mouth disease in children under 3 years old, and early detection and early treatment , Is the key to prevent the death of hand, foot and mouth disease cases.