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目的分析2011年1月—2016年12月惠州市发热伴出疹性疾病(rash and fever illness,RFIs)的病原谱构成及流行特征,为临床诊断、治疗和RFIs的预防控制提供科学依据。方法应用实时荧光定量聚合酶链反应、酶联免疫吸附测定方法和细菌分离鉴定方法对1 360例临床标本进行风疹、麻疹、肠道病毒、水痘-带状疱疹、登革热、人类小DNA病毒B19、伤寒副伤寒等病原学检测,并用Excel软件和χ~2检验对结果进行分析。结果 1 360例样本中检出688例RFIs病原体阳性标本,阳性率为50.59%。病原谱构成前4位为肠道病毒、麻疹病毒、水痘病毒和风疹病毒。年龄组不同感染的病原谱构成也不同:8月龄以下年龄组以麻疹病毒为主,8~月龄组以肠道病毒为主,风疹在16~岁年龄组的检出率高于其他年龄组,而水痘在8~岁年龄组的检出率高于其他年龄组;不同病原体在不同年龄组阳性率差异均有统计学意义(P<0.001),不同性别患者之间病原体检出率差异无统计学意义(P>0.05)。结论肠道病毒和麻疹病毒是本地RFIs感染的主要病原体。部分病原体的感染与年龄有一定的关联。积极推行水痘、麻疹、风疹、EV71等疫苗的接种是控制RFIs发病的主要措施。
Objective To analyze the epidemiological composition and epidemic characteristics of fever and fever illness (RFIs) from January 2011 to December 2016 in Huizhou City, and provide a scientific basis for clinical diagnosis, treatment and prevention and control of RFIs. Methods The clinical samples of rubella, measles, enterovirus, chickenpox-shingles, dengue fever, human small DNA virus B19 and human smallpox virus B virus were detected by real-time fluorescence quantitative polymerase chain reaction, enzyme-linked immunosorbent assay and bacterial isolation and identification method. Typhoid paratyphoid and other etiological testing, and using Excel software and χ ~ 2 test results were analyzed. Results A total of 688 RFIs positive specimens were detected in 1 360 samples. The positive rate was 50.59%. The top 4 pathogenic spectrums were enterovirus, measles virus, varicella virus and rubella virus. The composition of the pathogenic spectrum of different infections in different age groups is also different: the measles virus is mainly in the age group of less than 8 months, the enterovirus is the main group in the 8-month age group, and the detection rate of the rubella in the 16-year-old group is higher than that of other ages The detection rate of chickenpox in 8 ~ age group was higher than that of other age groups. The positive rates of different pathogens in different age groups were statistically different (P <0.001). The difference of pathogen detection rate among different sexes No statistical significance (P> 0.05). Conclusion Enterovirus and measles virus are the major pathogens of local RFIs infection. Some pathogen infection and age have some relevance. Active vaccination of varicella, measles, rubella, EV71 and other vaccines is the main measure to control the incidence of RFIs.