目的:了解手足口病( HFMD)病原、临床特征及其主要流行因素,为科学制定郑州市二七区HFMD的防控措施提供依据。方法:采用RT-PCR方法对河南省郑州市二七区HFMD定点医院2008~2012年住院HFMD患者的粪便标本2932份进行肠道病毒、肠道病毒71型( EV71)和柯萨奇病毒A16型( CoxA16)检测,并观察其临床特征,分析其主要流行因素。结果:2932份粪便标本中有2062份检出肠道病毒,其中748份EV71阳性,527份CoxA16阳性,787份其他肠道病毒阳性。2008、2009、2010、2011、2012年该地区住院HFMD患者病原体构成不全相同(χ2=109.741,P<0.001),EV71是2010年HFMD流行的主要病原体。肠道病毒的流行集中于3~7月份,4、5月份达到高峰;93.50%的肠道病毒感染发生于0.5~4.0岁儿童,其感染的型别与患儿的年龄、性别、居住地无关。201例重症HFMD患者中,EV71阳性90例,阳性率高于普通患者,主要表现为脑炎和无菌性脑膜炎,其中2例死亡(死于脑炎和肺水肿或肺出血)。结论:2008~2012年河南省郑州市二七区HFMD流行期间有多种肠道病毒流行, CoxA16和EV71是引起HFMD的主要病原体,EV71是导致重症病例和死亡病例的主要病原体。
Aim:To find out the state of the enterovirus infection and clinical characteristics of hand -foot-mouth disea-ses(HFMD) in order to make prevention and control strategy .Methods: Enterovirus, enterovirus 71 (EV71) and Cox-sackievirus A16(CoxA16) were diagnosed through RT-PCR in patients hospitalized with HFMD 2008-2012 in Erqi district of Zhengzhou city .Clinical characteristics of the patients with HFMD were also studied .Results: Among 2 932 patients with HFMD, the positive samples for EV71, CoxA16 and other enteroviruses were 748, 527 and 787 respectively.The an-nual epidemics of the pathogens were various from 2008 to 2012 (χ2 =109.741,P〈0.001).HFMD was mainly during summertime prevalent and peaked in April and May .Most ( 93 .50%) cases occurred in children who were between 6 months and 4 years old.Severe HFMD had a higher rate of EV 71 infection than mild patients .Among 201 patients with se-vere complications , 2 died of pulmonary edema and pulmonary hemorrhage .Conclusion: Several enteroviruses were epi-demic during the 2008-2012 HFMD epidemic period , among which , the CoxA16 and EV71 are the important pathogens of HFMD.EV71 infection is associated with most of the serious clinical manifestations and with all the deaths .