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 ›› 2018, Vol. 10 ›› Issue (2): 153-155.doi: 10.3969/j.issn.1674-3865.2018.02.019

• 临床研究 • 上一篇    下一篇

2014～2016年大连地区手足口病住院患儿病原学分析

王屹，景淑军，王大利，郑琦，杨光，刘晓梅   

  1. 116012 辽宁 大连，大连医科大学附属大连市儿童医院感染疾病科（王屹，景淑军，杨光，刘晓梅），中心实验室（王大利，郑琦）
  • 出版日期:2018-04-25 发布日期:2018-11-19
  • 通讯作者: 景淑军，E-mail:jingshujun2420@sina.com
  • 作者简介:王屹（1983-），男，医学硕士，主治医师。研究方向：儿童呼吸系统疾病和感染性疾病的诊治

Analysis of etiology of hospitalized children with hand-foot-mouth disease in Dalian from 2014 to 2016

WANG Yi，JING Shujun，WANG Dali，ZHENG Qi，YANG Guang，LIU Xiaomei   

  1.  Dalian Children's Hospital of Dalian Medical University，Dalian 116012，China
  • Online:2018-04-25 Published:2018-11-19

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摘要：
目的
分析2014～2016年大连地区手足口病住院患儿病原学构成，监测其病原学变化。
方法
选择2014～2016年每年6～9月大连医科大学附属大连市儿童医院感染疾病科收治住院且留取粪便标本的手足口病患儿1 165例为研究对象，采用磁珠柱法提取核酸，采用实时荧光定量PCR法检测特异性RNA核酸片段。
结果
（1）1 165例粪便标本中肠道病毒检测阴性91例，阳性1 074例。2014年阳性199例，其中EV71阳性48例、CA16阳性39例、其他肠道病毒阳性112例；2015年阳性320例，其中EV71阳性37例、CA16阳性57例、其他肠道病毒阳性226例；2016年阳性555例，EV71阳性127例、CA16阳性193例、其他肠道病毒阳性235例。（2）合并病毒性脑炎30例，肠道病毒检测阴性3例，阳性27例。2014年阳性12例，其中EV71阳性7例、CA16阳性1例、其他肠道病毒阳性4例；2015年阳性3例，EV71阳性1例、其他肠道病毒阳性2例；2016年阳性12例，其中EV71阳性5例、CA16阳性1例、其他肠道病毒阳性6例。（3）合并病毒性心肌炎12例，其他肠道病毒阳性10例，CA16阳性2例。
结论
大连地区手足口病病原学发生变化，其他肠道病毒感染已呈高发态势，其他肠道病毒感染所致病毒性脑炎、病毒性心肌炎比例也逐渐增高。

关键词: 手足口病, 病原学, 肠道病毒, 儿童

Abstract:
objective
To analyze the pathogenic composition of hospitalized children with handfootmouth disease in Dalian from 2014 to 2016 and monitor the variety of pathogen.
Methods
Stool samples were collected from hospitalized children who suffered from hand-foot-mouth disease from June to September during the period of 2014-2016 to extract nucleic acid by magnetic bead column method and to detect the specific RNA nucleic acid fragments by fluorescence PCR.
Results
（1） The stool samples of 1 165 cases were collected, 91 cases were negative in intestinal virus test, and 1 074 cases were positive, among which 199 cases in 2014, including EV71 in 48 cases, CA16 in 39 cases and other enterovirus in 112 cases; there were 320 cases in 2015, including EV71 in 37 cases, CA16 in 57 cases and other enterovirus in 226 cases; there were 555 cases in 2016, including EV71 in 127 cases, CA16 in 193 cases and other enterovirus in 235 cases. （2）There were 30 cases complicated by viral encephalitis, 3 cases of negative intestinal virus test and 27 cases positive. Among positive cases, there were 12 cases in 2014, including EV71 in 7 cases, CA16 in 1 case, and other enterovirus in 4 cases; there were 3 cases in 2015, including EV71 in 1 case and other enterovirus in 2 cases; there were 12 cases in 2016, including EV71 in 5 cases, CA16 in 1 case and other enterovirus in 6 cases.（3）There were 12 cases complicated by viral myocarditis, including other enterovirus in 10 cases and CA16 in 2 cases.
Conclusion
A pathogenic change has happened in hand-foot-mouth disease in Dalian, with the high frequency of other enterovirus infection, which also contributes to the significantly increasing cases of viral encephalitis or viral myocarditis.

Key words: Hand-foot-mouth disease, Etiology, Enteroviruses, Children