切换至 "中华医学电子期刊资源库"

中华妇幼临床医学杂志(电子版) ›› 2016, Vol. 12 ›› Issue (03) : 334 -338. doi: 10.3877/cma.j.issn.1673-5250.2016.03.015

所属专题: 文献

论著

普通型手足口病患儿肠道病毒病原学检测及其临床特点
林燕1,(), 刘磊2, 马才兴1   
  1. 1. 610091 成都市妇女儿童中心医院儿科
    2. 610051 成都,四川省疾病预防控制中心
  • 收稿日期:2016-04-11 修回日期:2016-05-20 出版日期:2016-06-01
  • 通信作者: 林燕

Pathogen detection and its clinical characteristics of children with ordinary hand, foot and mouth disease

Yan Lin1,(), Lei Liu2, Caixing Ma1   

  1. 1. Department of Pediatrics, Chengdu Women and children's Central Hospital, Chengdu 610091, Sichuan Province, China
    2. Sichuan Center for Disease Control and Prevention, Chengdu 610051, Sichuan Province, China
  • Received:2016-04-11 Revised:2016-05-20 Published:2016-06-01
  • Corresponding author: Yan Lin
  • About author:
    Corresponding author: Lin Yan, Email:
引用本文:

林燕, 刘磊, 马才兴. 普通型手足口病患儿肠道病毒病原学检测及其临床特点[J]. 中华妇幼临床医学杂志(电子版), 2016, 12(03): 334-338.

Yan Lin, Lei Liu, Caixing Ma. Pathogen detection and its clinical characteristics of children with ordinary hand, foot and mouth disease[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2016, 12(03): 334-338.

目的

探讨普通型手足口病(HFMD)患儿一般临床特点及其肠道病毒(EV)血清型分布特点,揭示普通型HFMD的流行特征。

方法

选择2014年3~9月于成都市妇女儿童中心医院门诊就诊,临床诊断为普通型HFMD的193例患儿为研究对象。其中,103例取得家长同意后咽拭子取样,采用实时荧光聚合酶链反应(RT-PCR)法进行EV检测,并鉴别其血清型。分析普通型HFMD患儿临床特点,并统计学比较柯萨奇病毒(Cox)A16 、EV71及其他EV感染的临床特点差异。本研究遵循的程序符合成都市妇女儿童中心医院人体试验委员会制定的伦理学标准,得到该委员会批准,征得受试对象监护人知情同意,并与之签署临床研究知情同意书。

结果

①本组193例普通型HFMD患儿中,年龄1~3岁为118例(61.1%),1~5岁为167例(86.5%);散居儿童为119例(61.7%);所有受试者均有咽峡部和(或)口腔疱疹,以及手部、足部和(或)臀部皮疹的临床表现,并预后良好。②本组103例HFMD患儿咽拭子样本EV阳性检出率为86.4%(89/103);89例EV阳性普通型HFMD患儿中,CoxA16阳性为57例(64.0%),EV71阳性为16例(18.0%),其他EV阳性为16例(18.0%)。③本组89例EV阳性普通型HFMD患儿不同血清型病例的年龄、性别构成比、生活范围构成比及变态反应史阳性率等一般临床资料比较,发热率、发热高峰温度、发热持续时间及并发症发生率等临床表现比较,以及白细胞计数及C反应蛋白(CRP)含量实验室等检查结果比较,差异均无统计学意义(P>0.05)。

结论

CoxA16是2014年成都市妇女儿童中心医院普通型HFMD的主要病原体。尚不能根据患儿的主要临床表现及特点,以及外周血白细胞计数和CRP含量检测结果推测可能的EV血清型。

Objective

To investigate the characteristics of general clinic data of children with ordinary hand, foot and mouth disease(HFMD) and the serotype distribution of enterovirus(EV) detection results, and to explore the epidemiological characteristics of ordinary HFMD.

Methods

From March to September, 2014, a total of 193 children who were diagnosed as ordinary HFMD in department of clinic service, Chengdu Women and children's Central Hospital, were chosen as study objects.The throat swab samples from the 103 children with their parents'permission, were collected and analyzed by real-time fluorescence polymerase chain reaction(RT-PCR) to get the EV serotypes. Clinical characteristics of 193 children with ordinary HFMD were summarized and compared the clinical characteristic differences among infection of Coxsackie virus(Cox)A16, EV71 and other EV by statistical method.The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Chengdu Women and children's Central Hospital.Informed consent was obtained from the parents of each participant.

Results

①Among 193 children with ordinary HFMD, 118 cases(61.1%) were 1-3 years old, 167 cases(86.5%) were 1-5 years old; 119 cases(61.7%)were scattered children.Oral mucosal pox or ulcer as well as hand, foot and buttocks rashes were observed in all 193 children, and the prognosis were good for all subjects.②The EV positive detection rate of throat swab samples of 103 ordinary HFMD children was 86.4%(89/103). Among the 89 ordinary HFMD children with EV positive, 57 cases(18.0%)were CoxA16 positive, 16 cases(18.0%) were EV71 positive, and 16 cases(18.0%) left were other EV positive.③Among the 89 ordinary HFMD children with EV positive, there were no significant differences among infection of CoxA16, EV71 and other EV in general clinic data such as the age, constituent ratio of gender and living range, positive rate of allergy history, etc.; Or in the clinical manifestations of fever rate, peak temperature, fever lasting time and incidence of complications; Also in laboratory examination such as white blood cell count and C-reactive protein(CRP), etc.(P>0.05).

Conclusions

CoxA16 infection was the main pathogen of ordinary HFMD in Chengdu Women and children's Central Hospital in 2014. The characteristics of clinical manifestations, white blood cell count and CRP content results of ordinary HFMD children can not speculated the possible serotype of EV.

表1 89例肠道病毒阳性普通型手足口病患儿不同血清型病例的临床特点比较
1
中华人民共和国国家卫生和计划生育委员会.手足口病诊疗指南(2010年版)[EB/OL].(2010-04-20).[2016-04-15].

URL    
2
董国庆,蒋红英,闵慧,等.手足口病22例病原学及临床分析[J].实用儿科临床杂志,2010,25(22):1723-1725.
3
茹维平,王彦霞,康锴,等.危重型手足口病临床症状及预警因素分析[J].郑州大学学报:医学版,2011,46(4):608-610.
4
国家卫生和计划生育委员会手足口病临床专家组.肠道病毒71型(EV71)感染重症病例临床救治专家共识[J].中华儿科杂志,2011,49(9):675-678.
5
张宏萍,周敏,陆仁飞,等.南通地区手足口病患儿的病原学检测及临床特点分析[J].实用医学杂志,2015,31(5):762-765.
6
王明英,周玲.昆明地区9 333例儿童手足口病临床流行病学分析[J/CD].中华妇幼临床医学杂志:电子版,2012,8(4):426-427.
7
殷继东,伍仕敏,项杰,等.2011年武汉及周边城市手足口病病原学及流行病学研究[J].军事医学,2013,37(6):435-438.
8
杜曾庆,吴茜,王美芬,等.1 764例手足口病的临床诊治特点及病原学研究[J].中华妇幼临床医学杂志:电子版,2012,8(1):60-63.
9
赵明伍,朱琳,潘志平,等.遵义市2011年手足口病实验室检测结果分析[J].中国卫生检验杂志,2013,23(3):731-732.
10
Puenpa J, Mauleekoonphairoj J, Linsuwanon P, et al.Prevalence and characterization of enterovirus infections among pediatric patients with hand foot mouth disease, herpangina and influenza like illness in Thailand, 2012[J].PLoS One, 2014, 9(6):e98888.
11
张寿斌,廖华,黄呈辉,等,深圳237例手足口病肠道病毒血清型基因及临床特征[J].中国当代儿科杂志,2008,10(1):38-41.
12
张晨宇,李树锦,程邦宁.手足口病病原体EV71和CoxA16的研究进展[J].安徽预防医学杂志,2013,19(4):279-282.
13
石世同,吴茜,杜曾庆,等.手足口病并发神经系统损害117例临床分析[J/CD].中华妇幼临床医学杂志:电子版,2011,7(2):151-154.
14
Chen CS, Yao YC, Lin SC, et al.Retrograde axonal transport: a major transmission route of enterovirus 71 in mice[J].J Virol, 2007, 81(17):8996-9003.
15
孙德宏,于永锋,赵桂娟,等.手足口病患儿肠道病毒71感染相关免疫功能变化及其临床意义[J/CD].中华妇幼临床医学杂志:电子版,2012,8(4):437-440.
16
田波,段海生,容一兵,等.肠道病毒71型分子流行病学研究进展[J].中国病毒学,2004,19(4):426-429.
17
Tran CB, Nguyen HT, Phan HT, et al.The seroprevalence and seroincidence of enterovirus71 infection in infants and children in Ho Chi Minh City, Viet Nam[J].PLoS One, 2011, 6(7):e21116.
18
杨晓泉,叶晓明,农少云,等.手足口病患儿的免疫功能[J].实用儿科临床杂志,2011,26(22):1764,1768.
19
柳楠,吴志豪,邱少富,等.肠道病毒71型致病机制研究进展[J].军事医学,2013,37(12):955-959.
20
孙春艳,徐书珍,张定荣,等.手足口病患儿早期抗炎-促炎机制及免疫功能变化的研究[J/CD].中华妇幼临床医学杂志:电子版,2014,10(5):658-661.
[1] 张璇, 马宇童, 苗玉倩, 张云, 吴士文, 党晓楚, 陈颖颖, 钟兆明, 王雪娟, 胡淼, 孙岩峰, 马秀珠, 吕发勤, 寇海燕. 超声对Duchenne肌营养不良儿童膈肌功能的评价[J]. 中华医学超声杂志(电子版), 2023, 20(10): 1068-1073.
[2] 张宝富, 俞劲, 叶菁菁, 俞建根, 马晓辉, 刘喜旺. 先天性原发隔异位型肺静脉异位引流的超声心动图诊断[J]. 中华医学超声杂志(电子版), 2023, 20(10): 1074-1080.
[3] 韩丹, 王婷, 肖欢, 朱丽容, 陈镜宇, 唐毅. 超声造影与增强CT对儿童肝脏良恶性病变诊断价值的对比分析[J]. 中华医学超声杂志(电子版), 2023, 20(09): 939-944.
[4] 刘婷婷, 林妍冰, 汪珊, 陈幕荣, 唐子鉴, 代东伶, 夏焙. 超声衰减参数成像评价儿童代谢相关脂肪性肝病的价值[J]. 中华医学超声杂志(电子版), 2023, 20(08): 787-794.
[5] 周钰菡, 肖欢, 唐毅, 杨春江, 周娟, 朱丽容, 徐娟, 牟芳婷. 超声对儿童髋关节暂时性滑膜炎的诊断价值[J]. 中华医学超声杂志(电子版), 2023, 20(08): 795-800.
[6] 罗晨, 宗开灿, 李世颖, 傅应亚. 微小RNA-199a-3p调控CD4T细胞表达参与肺炎支原体肺炎患儿免疫反应研究[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 569-574.
[7] 米洁, 陈晨, 李佳玲, 裴海娜, 张恒博, 李飞, 李东杰. 儿童头面部外伤特点分析[J]. 中华损伤与修复杂志(电子版), 2023, 18(06): 511-515.
[8] 中华医学会烧伤外科学分会小儿烧伤学组. 儿童烧伤早期休克液体复苏专家共识(2023版)[J]. 中华损伤与修复杂志(电子版), 2023, 18(05): 371-376.
[9] 邬文莉, 万约翰, 高梓君, 黎凡. 外科手术联合口服西罗莫司治疗儿童口腔颌面部淋巴管畸形[J]. 中华口腔医学研究杂志(电子版), 2023, 17(05): 345-352.
[10] 王蕾, 王少华, 牛海珍, 尹腾飞. 儿童腹股沟疝围手术期风险预警干预[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(06): 768-772.
[11] 李芳, 许瑞, 李洋洋, 石秀全. 循证医学理念在儿童腹股沟疝患者中的应用[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(06): 782-786.
[12] 吕垒, 冯啸, 何凯明, 曾凯宁, 杨卿, 吕海金, 易慧敏, 易述红, 杨扬, 傅斌生. 改良金氏评分在儿童肝豆状核变性急性肝衰竭肝移植手术时机评估中价值并文献复习[J]. 中华肝脏外科手术学电子杂志, 2023, 12(06): 661-668.
[13] 卓少宏, 林秀玲, 周翠梅, 熊卫莲, 马兴灶. CD64指数、SAA/CRP、PCT联合检测在小儿消化道感染性疾病鉴别诊断中的应用[J]. 中华消化病与影像杂志(电子版), 2023, 13(06): 505-509.
[14] 刘笑笑, 张小杉, 刘群, 马岚, 段莎莎, 施依璐, 张敏洁, 王雅晳. 中国学龄前儿童先天性心脏病流行病学研究进展[J]. 中华临床医师杂志(电子版), 2023, 17(9): 1021-1024.
[15] 李静, 张玲玲, 邢伟. 兴趣诱导理念用于小儿手术麻醉诱导前的价值及其对家属满意度的影响[J]. 中华临床医师杂志(电子版), 2023, 17(07): 812-817.
阅读次数
全文


摘要