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目的对2009—2013年山东省济南地区手足口病(HFMD)的病原及流行特征进行分析,了解HFMD的发病特点及流行趋势,为HFMD防控提供科学依据。方法选取济南地区2009—2013年临床诊断为HFMD的病例为对象,收集各县(市、区)疾病预防控制中心对辖区内发生的HFMD病例的流行病学调查资料,采集患者发病1周内的粪便、咽拭子等标本共计3 792例,采用肠道病毒通用(PE)、肠道病毒71型(EV71)和柯萨奇病毒A组16型(Cox A16)特异性引物通过逆转录聚合酶链式反应(RT-PCR)进行病原学分析;采用SPSS 11.0统计软件对流行病学资料进行统计分析。结果 2009—2013年济南地区3 792例HFMD患者(包括138例重症)标本中,2 843例检测到肠道病毒,阳性率为74.97%;其中1 143例为EV71阳性(40.20%),955例为Cox A16阳性(33.59%),其他肠道病毒(EV)阳性737例(25.92%),EV71和Cox A16混合感染阳性8例(0.28%);138例重症患者的感染病原主要为EV71(86.36%);HFMD患者主要集中于<4岁儿童(82.15%),发病高峰集中于4—5月份(31.70%),肠道病毒阳性检出率与性别无关;5年间呈现出EV71和Cox A16交替流行的态势,病原构成比之间差异有统计学意义(χ2=116.38,P<0.05)。结论山东省济南地区2009—2013年HFM D病原以EV71和Cox A16为主,并交替流行;EV71是引起HFMD重症及死亡病例的主要毒株类型。
Objective To analyze the etiopathogenisis and epidemiological characteristics of HFMD from 2009 to 2013 in Jinan City, Shandong Province, so as to understand the characteristics and epidemic trend of HFMD and provide a scientific basis for the prevention and control of HFMD. Methods The cases of HFMD clinically diagnosed in Jinan from 2009 to 2013 were selected to collect the epidemiological investigation data of HFMD cases in all districts (CDCs) of each county (city, district), and the data were collected within 1 week A total of 3 792 specimens of feces and throat swabs were obtained by reverse transcription polymerase (RT) analysis using specific primers for enterovirus (EV), enterovirus 71 (EV71) and coxsackievirus A group 16 (Cox A16) Epidemiological data were analyzed by using SPSS 11.0 statistical software. Results Of the 3 792 HFMD patients (including 138 severe cases) in Jinan City from 2009 to 2013, 2 843 cases of enterovirus were detected, the positive rate was 74.97%. Among them, 1 143 cases were EV71 positive (40.20%) and 955 cases (33.59%) were positive for Cox A16, 737 (25.92%) were positive for other enterovirus (EV) and 8 (0.28%) were positive for EV71 and Cox A16 infection. The prevalence of EV71 infection in the 138 severe cases was EV71 %); HFMD patients mainly concentrated in <4 years old children (82.15%), the peak incidence concentrated in April-May (31.70%), enterovirus positive detection rate has nothing to do with sex; 5 years showed EV71 and Cox A16 alternating The prevalence of the pathogen composition ratio between the difference was statistically significant (χ2 = 116.38, P <0.05). Conclusion The prevalence of HFM D in Jinan area in 2009-2013 was mainly EV71 and Cox A16 in Jinan area. EV71 was the main type of HFMD in severe and fatal cases.