79例重症手足口病儿童病原学研究.docVIP

79例重症手足口病儿童病原学研究【摘要】 目的 分析重症手足口病的病原体，为预防和控制重症手足口病提供依据。方法 采集我院PICU收治的79例重症手足口病患儿的粪便、肛拭子、咽拭子、疱疹液等标本进行RTPCR 定性检测肠道病毒通用引物及EV71和CA16 的VP1 基因的特异性引物进行RT PCR 鉴定。结果 共收集标本257份，肠道病毒通用引物阳性164例，EV71阳性118例，CoA16阳性40例，其他6例。其中粪便标本79份，病毒分离阳性61份, 阳性率为772 %；肛拭子79 份，病毒分离阳性53 份，阳性率为671 %；咽拭子79份，病毒分离阳性41 份，阳性率为519 %；疱疹液20份，病毒分离阳性9 份，阳性率为45%。结论 EV71是引起重症手足口病的主要病原体。粪便、肛拭子、咽拭子、疱疹液的阳性率不同，以粪便阳性率最高。 【关键词】 手足口病;肠道病毒; EV71; COA16 Pathogens analysis of 79 cases severe HFMD LUO Xufeng, ZHOU Tao, LIU Yuling, et al.Department of Pediatrics Boai Hospital of Zhongshan City gongdong province,Zhognshan 528400,China 【Abstract】 Objective To analyzethecausativeagentofseverehandfoot mouth disease(HFMD) and provide the basisfortheprevention and controlof severe HFMDMethods 79 cases of severe HFMD childrens stool, rectalswab,throat swab, herpesfluid specimens were collected for RTPCR,qualitative detection of enterovirusuniversal primersEV71 and COA16 of the VP1 genes pecific primers by RT PCRResults 257specimens were collected, enterovirus universal primers was positivein 164 cases,118 cases of EV71positive,CoA 16 positivein 40 cases,79 stool specimens,virus isolation,61 were positive,the positive rate was 772%,79 rectal swabs,53 were positive for virus isolation,the positive rate was 671%,79 throat swabs,virus isolation,41were positive, the positive rate 519%,9 herpes fluid of 20 virus isolationpositive, the positive rate of 45%Conclusion EV71 is the main pathogens of severeHFMDthe positive rate of stool,rectal swabs,throat swabs, and herpes fluid is inconsistent. 【Key words】 HFMD;Enterovirus;EV71;COA16 -------------------------------------------------------------------------------- 基金项目：重症手足口病综合救治与机制研究(项目编号：20101A008) 作者单位：528400 中山市博爱医院儿科 通讯作者：付四毛 手足口病(hand foot and mouth disease，HFMD) 是由肠道病毒感染引起的一种传染性疾病，引起本病的肠道病毒有20多种(型)，其中以肠道病毒71型(Enterovirus 71，EV71)和柯萨奇病毒A16型(Coxsackievirus A16，COA16)最常见，两种病毒感染常交替出现，成为手足口病的主要病原体，其中EV71感染易引起暴发流行，并且易合并中枢神经系统感染和神经源性肺水肿而危及患儿生命。2009年4~8月