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[目的]了解济南市手足口病病原学特征,为制定防治措施提供科学依据。[方法]对2011年济南市831例临床诊断手足口病病例标本,采用实时荧光RT-PCR法检测人肠道病毒(PE)、肠道病毒71型(EV71)和柯萨奇病毒A组16型(CoxA16)特异性核酸。[结果]831例手足口病患者标本中,肠道病毒总阳性率为76.05%,其中EV71、CoxA16和其他肠道病毒核酸阳性率分别为40.19%、18.29%和17.57%。肠道病毒阳性率,粪便标本为75.34%,咽拭子为93.75%(P<0.05);3岁最高(83.41%),≥10岁最低(54.55%);男性为77.10%,女性为74.38%(P>0.05);托幼儿童为83.00%,散居儿童为70.60%,学生为52.38%,其他为50.00%;平阴县最高(93.22%),商河县最低(46.88%)。粪便标本阳性率,病后24h内采集的为86.67%,1～3d采集的为83.11%,4～7d采集的为77.52%,8～14d采集的为62.50%,15～21d采集的为51.02%,22～37d采集的为35.71%(P<0.01)。[结论]EV71是济南市2011年手足口病的主要病原体,及时采集标本可以提高阳性检出率。
[Objective] To understand the etiological characteristics of hand-foot-mouth disease in Ji’nan city and provide scientific basis for making prevention and cure measures. [Methods] 831 cases of hand-foot-mouth disease diagnosed in Jinan City in 2011 were detected by real-time fluorescence RT-PCR method for human enterovirus (EV), enterovirus 71 (EV71) and Coxsackievirus A (CoxA16) -specific nucleic acid. [Results] The total positive rate of enterovirus in 831 HFMD patients was 76.05%. The positive rates of EV71, CoxA16 and other enterovirus nucleic acids were 40.19%, 18.29% and 17.57% respectively. The positive rate of enterovirus was 75.34% in stool samples and 93.75% in throat swabs (P <0.05), the highest was in 3 years old (83.41%), the lowest was in aged> 10 years (54.55%), the rate was 77.10% in males and 74.38% (P> 0.05). The children in kindergartens and nurseries were 83.00%, 70.60% and 52.38% respectively, while the others were 50.00%. The highest in Pingyin County was 93.22% and the lowest in Shanghe County was 46.88%. The positive rate of faecal specimens was 86.67% within 24 h after the illness, 83.11% from 1 to 3 days, 77.52% from 4 to 7 days, 62.50% from 8 to 14 days, 51.02% from 15 to 21 days, , 35.71% (P <0.01) collected from 22 ~ 37d. [Conclusion] EV71 is the major pathogen of hand, foot and mouth disease in Jinan City in 2011, and timely collection of specimens can increase the positive detection rate.