69例手足口病临床特点及合并甲损伤相关因素分析
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摘要
目的探讨手足口病临床特点及合并甲损伤相关因素分析。方法采集2014年3月-2015年9月在郑州市儿童医院感染科临床诊断的69例手足口病患儿的临床资料和粪便标本,采用实时荧光定量PCR法进行肠道病毒核酸检测;于患儿出院后1周,以后每隔2周随访至30周,询问患儿有无甲损伤,并详细记录。结果手足口病致病原以EV71及CA16为主,2种病原共占62.3%(43/69),其次是CA6,占43.5%(30/69)。甲损伤与发热、食欲差、咽喉炎、上呼吸道感染症状、CA16感染、EV71感染及神经系统症状等无明显相关性(P>0.05);甲损伤与口腔疱疹、浅溃疡面,手、足底、臀部斑丘疹、丘疱疹及CA6感染有相关性。结论 CA6已经成为手足口病优势病原;甲损伤可能与多种肠道病毒感染有关。
Objective To analyze the clinical characteristics of 69 cases of hand,foot and mouth disease( HFMD) and factors associated with nail abnormalities in the children. Methods Clinical data and stool samples were collected from 69 children with HFMD who visited doctor during March 2014- September 2015 in the Infection Department of Zhengzhou Children's Hospital. And the nucleic acid of enterovirus was detected by real- time fluorescent quantitative polymerase chain reaction( PCR).Nails discoloration was followed- up and recorded every two weeks until 30 weeks after 1 week's leaving hospital. Results The major pathogens for HFMD were EV71 and CA16( 62. 3%,43 /69),followed by CA6( 43. 5%,30 /69). Nail abnormalities had no significant relationship with fever,loss of appetite,pharyngitis,upper respiratory tract infection,CA16 infection,EV71 infection and nervous system symptoms( P > 0. 05),but it was closely correlated with vesicles / ulcers on mouth,hand,feet,nappy area and CA6 infection. Conclusion CA6 was one of the major pathogens for HFMD. Nail abnormalities were related to multiple enterovirus infections.
Objective To analyze the clinical characteristics of 69 cases of hand,foot and mouth disease( HFMD) and factors associated with nail abnormalities in the children. Methods Clinical data and stool samples were collected from 69 children with HFMD who visited doctor during March 2014- September 2015 in the Infection Department of Zhengzhou Children's Hospital. And the nucleic acid of enterovirus was detected by real- time fluorescent quantitative polymerase chain reaction( PCR).Nails discoloration was followed- up and recorded every two weeks until 30 weeks after 1 week's leaving hospital. Results The major pathogens for HFMD were EV71 and CA16( 62. 3%,43 /69),followed by CA6( 43. 5%,30 /69). Nail abnormalities had no significant relationship with fever,loss of appetite,pharyngitis,upper respiratory tract infection,CA16 infection,EV71 infection and nervous system symptoms( P > 0. 05),but it was closely correlated with vesicles / ulcers on mouth,hand,feet,nappy area and CA6 infection. Conclusion CA6 was one of the major pathogens for HFMD. Nail abnormalities were related to multiple enterovirus infections.
引文
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[2]Bernier V,Labrèze C,Bury F,et al.Nail matrix arrest in the course of hand,foot and mouth disease[J].Eur J Pediatr,2001,160(11):649-651
[3]中华人民共和国卫生部.手足口病诊疗指南(2010年版)[J].国际呼吸杂志,2010,30(24):1473-1475.
[4]Wu PC,Huang LM,Kao CL,et al.An outbreak of coxsackievirus A16 infection:comparison with other enteroviruses in a preschool in Taipei[J].J Microbiol Immunol Infect,2010,43(4):271-277
[5]Ljubin-Sternak S,Slavic-Vrzic V,Vilibic'-Cˇavlek T,et al.Outbreak of hand,foot and mouth disease caused by Coxsackie A16virus in a childcare centre in Croatia,February to March 2011[J].Euro Surveill,2011,16(21),ppi:19875.
[6]Kobayashi M,Makino T,Hanaoka N,et al.Clinical manifestations of coxsackievirus A6 infection associated with a major outbreak of hand,foot,and mouth disease in Japan[J].Jpn J Infect Dis,2013,66(3):260-261.
[7]胡海赟,乔蓉,沈琦,等.2009-2011年上海市手足口病病原学检测及其临床特点分析[J].中华实验和临床病毒学杂志,2012,26(5):341-343.
[8]查杰,封琦,马智龙.2010-2013年江苏省泰州市非EV71和非Cox A16型手足口病肠道病毒病原谱及Cox A6VP1基因特征分析[J].中华流行病学杂志,2014,35(10):1181-1182.
[9]Wei SH,Huang YP,Liu MC,et al.An outbreak of coxsackievirus A6 hand,foot,and mouth disease associated with onychomadesis in Taiwan 2010[J].BMC Infect Dis,2011,11:346.
[10]Davia JL,Bel PH,Ninet VZ,et al.Onychomadesis outbreak in Valencia,Spain associated with hand,foot,and mouth disease caused by enteroviruses[J].Pediatr Dermatol,2011,28(1):1-5.
[11]Navarro ME,Almagro LD,Jaldo JR,et al.Outbreak of hand,foot and mouth disease with onychomadesis caused by Coxsackie virus A16 in Granada[J].An Pediatr(Barc),2015,82(4):235-241.
[12]Osterback R,Vuorinen T,Linna M,et al.Coxsackievirus A6 and hand,foot,and mouth disease,Finland[J].Emerg Infect Dis,2009,15(9):1485-1488.
[13]Shikuma E,Endo Y,Fujisawa A,et al.Onychomadesis developed only on the nails having cutaneous lesions of severe hand-footmouth disease[J].Case Rep Dermatol Med,2011,2011:324193.
[14]李垣君,张金桃,朱冰,等.120例儿童甲脱落病例相关因素分析[J].中华皮肤科杂志,2013,46(8):583-585.
[15]Cabrerizo M,De Miguel T,Armada A,et al.Onychomadesis after a hand,foot,and mouth disease outbreak in Spain 2009[J].Epidemiol Infect,2010,138(12):1775-1778.
[16]Bettoli V,Zauli S,Toni G,et al.Onychomadesis following hand,foot,and mouth disease:a case report from Italy and review of the literature[J].Int J Dermatol,2013,52(6):728-730.
[2]Bernier V,Labrèze C,Bury F,et al.Nail matrix arrest in the course of hand,foot and mouth disease[J].Eur J Pediatr,2001,160(11):649-651
[3]中华人民共和国卫生部.手足口病诊疗指南(2010年版)[J].国际呼吸杂志,2010,30(24):1473-1475.
[4]Wu PC,Huang LM,Kao CL,et al.An outbreak of coxsackievirus A16 infection:comparison with other enteroviruses in a preschool in Taipei[J].J Microbiol Immunol Infect,2010,43(4):271-277
[5]Ljubin-Sternak S,Slavic-Vrzic V,Vilibic'-Cˇavlek T,et al.Outbreak of hand,foot and mouth disease caused by Coxsackie A16virus in a childcare centre in Croatia,February to March 2011[J].Euro Surveill,2011,16(21),ppi:19875.
[6]Kobayashi M,Makino T,Hanaoka N,et al.Clinical manifestations of coxsackievirus A6 infection associated with a major outbreak of hand,foot,and mouth disease in Japan[J].Jpn J Infect Dis,2013,66(3):260-261.
[7]胡海赟,乔蓉,沈琦,等.2009-2011年上海市手足口病病原学检测及其临床特点分析[J].中华实验和临床病毒学杂志,2012,26(5):341-343.
[8]查杰,封琦,马智龙.2010-2013年江苏省泰州市非EV71和非Cox A16型手足口病肠道病毒病原谱及Cox A6VP1基因特征分析[J].中华流行病学杂志,2014,35(10):1181-1182.
[9]Wei SH,Huang YP,Liu MC,et al.An outbreak of coxsackievirus A6 hand,foot,and mouth disease associated with onychomadesis in Taiwan 2010[J].BMC Infect Dis,2011,11:346.
[10]Davia JL,Bel PH,Ninet VZ,et al.Onychomadesis outbreak in Valencia,Spain associated with hand,foot,and mouth disease caused by enteroviruses[J].Pediatr Dermatol,2011,28(1):1-5.
[11]Navarro ME,Almagro LD,Jaldo JR,et al.Outbreak of hand,foot and mouth disease with onychomadesis caused by Coxsackie virus A16 in Granada[J].An Pediatr(Barc),2015,82(4):235-241.
[12]Osterback R,Vuorinen T,Linna M,et al.Coxsackievirus A6 and hand,foot,and mouth disease,Finland[J].Emerg Infect Dis,2009,15(9):1485-1488.
[13]Shikuma E,Endo Y,Fujisawa A,et al.Onychomadesis developed only on the nails having cutaneous lesions of severe hand-footmouth disease[J].Case Rep Dermatol Med,2011,2011:324193.
[14]李垣君,张金桃,朱冰,等.120例儿童甲脱落病例相关因素分析[J].中华皮肤科杂志,2013,46(8):583-585.
[15]Cabrerizo M,De Miguel T,Armada A,et al.Onychomadesis after a hand,foot,and mouth disease outbreak in Spain 2009[J].Epidemiol Infect,2010,138(12):1775-1778.
[16]Bettoli V,Zauli S,Toni G,et al.Onychomadesis following hand,foot,and mouth disease:a case report from Italy and review of the literature[J].Int J Dermatol,2013,52(6):728-730.