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目的探讨2011-2013年手足口病(HFMD)病原体变化趋势。方法采集4 064例在我院就诊的HFMD患者的咽拭子标本并提取核酸,采用实时荧光定量PCR方法检测肠道病毒通用型(EV),肠道病毒71型(EV71)及柯萨奇病毒A组16型(CA16)。结果 3年间6岁以上患儿占96.0%;发病以5~7月份为主,占73.5%。2011-2013年HFMD患者EV71、CA16和未分型肠道病毒的检出率依次为42.6%、35.3%、18.5%,16.1%、22.6%、11.5%,41.3%、42.1%、70.0%,差异有统计学意义(掊2=343.3,P<0.05)。2013年EV71、CA16检出率明显低于2011、2012年,未分型病毒检出率明显增高(P均<0.017)。613例重症HFMD患儿中,EV71感染占59.2%、CA16感染占11.1%,未分型病毒感染占29.7%,且均以肺炎合并脑干脑炎为主。结论 2011-2013年HFMD病原谱发生了变化,未分型肠道病毒增多,需引起重视。
Objective To explore the trend of pathogen of HFMD from 2011 to 2013. Methods Throat swab samples from 4 064 HFMD patients treated in our hospital were collected and nucleic acids were extracted. Real-time fluorescence quantitative PCR was used to detect EV, EV71 and Coxsackie virus A group of 16 (CA16). Results 3 years of children over the age of 6 accounted for 96.0%; incidence of 5 to 7 months, accounting for 73.5%. The detection rates of EV71, CA16 and undifferentiated enterovirus in HFMD patients from 2011 to 2013 were 42.6%, 35.3%, 18.5%, 16.1%, 22.6%, 11.5%, 41.3%, 42.1% and 70.0%, respectively There was statistical significance (掊 2 = 343.3, P <0.05). In 2013, the detection rate of EV71 and CA16 was significantly lower than that of 2011, and the detection rate of undivided virus was significantly higher in 2012 (all P <0.017). Among 613 children with severe HFMD, EV71 infection accounted for 59.2%, CA16 infection accounted for 11.1%, non-type virus infection accounted for 29.7%, and pneumonia were associated with encephalitis encephalitis. Conclusion The epidemic spectrum of HFMD changed from 2011 to 2013, and the number of undifferentiated enteroviruses increased.