161例手足口病实验室确诊病例病原学分型与临床特点分析.docVIP

161例手足口病实验室确诊病例病原学分型与临床特点的分析 　　摘要：目的 了解我市手足口病的病原学分型及流行病学特征，分析各病原学分型与临床特点的联系。方法 对我市2011～2014年实验室确诊的161例手足口病例的病原学分型进行分析，比较各病原学分型的临床特点有无差异。结果 161例手足口病实验室确诊病例中EV71分型55例，占34.16%，CoxA16分型54例，占33.54%，其他肠道病毒52例，占32.30%。2011～2014年病原学分型逐年有所变化，其中EV71所占比重有下降趋势。48例重症患者中27例为EV71阳性，13例为CoxA16阳性，8例为其他肠道病毒。结论 我市手足口病各年流行的肠道病毒不同，各型肠道病毒引起的手足口病临床表现有所不同，重症病例大部分由EV71引起。早期诊断，对有重症倾向的病例早期干预，可以降低危重患者的病死率。 　　关键词：手足口病；病原学；临床特点 　　Abstract：Objective To understand the pathogen types and epidemiology characters of hand，foot and mouth disease（HFMD）within Guanghan city；to analyse the relationship between different pathogen types and clinical peculiarities.Methods To analyse the pathogen types of 161 hand，foot and mouth disease（HFMD）cases which happened in Guanghan city from 2011-2014；to compare the differences among different pathogen types and clinical peculiarities.Results Among 161 hand，foot and mouth（HFMD）cases，the pathogen types and ratio numbers were：55 cases were caused by enterovirus 71（EV-71），34.16 percent；54 cases were caused by coxsackievirus A16（Cox A16），33.54 percent；the rest 52 cases were caused by other enterovirus and the ratio was 32.30 percent.From 2011 to 2014，the pathogen types changed gradually，the incidence rate of enterovirus 71（EV-71）showed the tendency of decrease.For the most severe 48 patients，there were 27 cases with enterovirus 71（EV-71）positive；13 cases with coxsackievirus A16（Cox A16）positive；8 cases with other enterovirus infectionConclusion There were different types of enterovirus led to hand，foot and mouth disease（HFMD）in Guanghan city in different years；which induced different clinical symptoms.Most severe cases were caused by enterovirus 71（EV-71）.Early diagnosis，early intervention are suggested to reduce death ratio of severe patients. 　　Key words：Hand，foot and mouth disease（HFMD）；Pathogen；Clinical peculiarity 　　手足口病是由一组肠道病毒引起的急性传染病，多发生于5岁以下婴幼儿，以手、足、口腔等部位皮肤粘膜的皮疹、疱疹、溃疡为典型表现，少数患儿可引起心肌炎、肺水肿、无菌性脑脊髓膜炎、脑炎等并发症，个别重症患儿病情发展快，导致死亡。自2008年将手足口病纳入丙类传染病管理后，我市手足口病发病呈逐年上升趋势