ISSN 1674-3865  CN 21-1569/R
主管：国家卫生健康委员会
主办：中国医师协会
　　　辽宁省基础医学研究所
　　　辽宁中医药大学附属医院
中国中西医结合儿科学

中国中西医结合儿科学 ›› 2015, Vol. 7 ›› Issue (6): 553-555.doi: 10.3969/j.issn.1674-3865.2015.06.007

• 临床研究 • 上一篇    下一篇

不典型手足口病患儿122例临床特点分析

刘艳,王大利,孙頔,高艳慧   

  1. 116035 大连,大连市妇女儿童医疗中心感染科(刘艳,孙頔,高艳慧)； 116012大连,大连市儿童医院中心实验室(王大利)
  • 出版日期:2015-12-25 上线日期:2018-11-19
  • 通讯作者: 刘艳,E-mail：ly88lxd@sina.com
  • 作者简介:刘艳(1964-),女,医学博士,主任医师。研究方向：手足口病基础与临床研究、风湿病的诊治

Clinical feasures of atypical hand, foot and mouth disease in 122 children

LIU Yan,WANG Dali，SUN Di,GAO Yanhui   

  1. Infection Department,Dalian Women and Children's Medical Center, Dalian 116035，China.
  • Published:2015-12-25 Online:2018-11-19

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摘要：
目的: 分析儿童不典型手足口病的临床特点。
方法: 收集并分析2013-06/09在大连市儿童医院确诊为不典型手足口病患儿122例的临床资料。
结果: 122例不典型手足口病患儿发病高峰为8月份,斑丘疹或疱疹分布于耳部、口周、躯干及四肢分别为62%(76/122)、69%(84/122)、66%(81/122)及100%(122/122)。口腔以外黏膜受累21%(26/122),中枢神经系统感染占19%(23/122),无危重症病例发生。肠道病毒71型(EV71)、柯萨奇病毒A组16型(CA16)、柯萨奇病毒A组10型(CA10)及柯萨奇病毒A组6型(CA6)感染分别为1%(1/91)、1%(1/91)、0(0/93)及84%(78/93)。病后1周至2个月指趾甲缺失占45%(44/97)。
结论: 不典型手足口病主要病原为CA6,发病高峰在8月份。皮肤、黏膜广泛受累,也可累及中枢神经系统,恢复期可出现指趾甲缺失,预后好。

关键词: 不典型手足口病, 诊断, 柯萨奇病毒A6, 儿童

Abstract:
Objective：To study the clinical features of atypical hand, foot and mouth disease.
Methods：The clinical data of 122 patients with atypical hand, foot and mouth disease in N0.6 Internal Ward in Dalian Woman and Children's Hospital between Jun. 2013 to Sep. 2013 were collected and analyzed.
Results：Peak incidence of atypical hand, foot and mouth disease occurred in Aug. 2013.Frequency of vesicles and papules over ears, faces, trunks and limbs were 62%（76/122）,69%(84/122),66%（81/122）and 100%（122/122）respectively. About 21%（26/122）patients had mucous involved besides oral mucous, and 19%(23/122) patients had severe hand, foot and mouth disease. All patients fully recovered. Positive detection rate on EV71 was 1%(1/91),CA16 1%(1/91),CA10 0(0/93) and CA6 84%(78/93). About 45%(44/97) patients developed onychomadesis 1 week to 2 months after onset of atypical hand, foot and mouth disease.ConclusionCA6 is the main pathogen of 122 patients with atypical hand, foot and mouth disease in Dalian in 2013，and the peak incidence occurs in August. Atypical hand, foot and mouth disease involves skin and mucous extensively. Some patients progress to severe cases and develop onychomadesis during the recovery period, but prognosis is good.

Key words: Atypical hand, foot and mouth disease, diagnosis, CA6, Children