手足口病和疱疹性咽峡炎流行病学和病原学特征分析
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摘要
目的探讨手足口病(hand-foot-mouthdisease,HFMD)流行病学和病原学特征,并与疱疹性咽峡炎(herpangina,HA)进行对比。方法选取2017年6月-2018年6月海口市人民医院儿科收治的HFMD 68例和HA 38例患儿进行分析,收集患儿的咽拭子标本并送至该院疾控中心进行实时荧光定量(RT)-PCR法对肠道病毒的VP1基因分析,记录患儿的人口统计学信息、临床表现和实验室检验结果。结果共检出14种肠道病毒基因型,CVA6是HFMD最常见的基因型,CVA2是引起HA的主要基因型。特定致病性肠道病毒基因型与一些可能提供的临床症状之间存在关联。结论 CVA6、CVA10和CVA16是导致HFMD主要病毒基因型,HA患儿中CVA2病毒基因型占大多数。
Objective To investigate the epidemiological and pathogenic characteristics of hand-foot-mouth disease(HFMD)of children, and differentiate it from herpetic angina(herpangina, HA). Methods 68 children with HFMD and 38 children with HA were enrolled in Haikou People's Hospital from June 2017 to June 2018. Throat swab specimens were collected and sent to CDC for real-time quantitative RT-PCR analysis of VP1 gene, and so detection of enteroviruses. The demographic data, clinical manifestations, and laboratory test results were also analyzed. Results A total of 14 genotypes of enteroviruses were detected in this study. Coxsackievirus A6(CVA6) was the most common pathogenic genotype of HFMD, and CVA2 was the major genotype causing HA. Specific genotypes of pathogenic enterovirus were associated with some possible clinical symptoms. Conclusions CVA6,CVA10 and CVA16 are the major pathogens of HFMD, while CVA2 is involved in most of the HA cases in children.
Objective To investigate the epidemiological and pathogenic characteristics of hand-foot-mouth disease(HFMD)of children, and differentiate it from herpetic angina(herpangina, HA). Methods 68 children with HFMD and 38 children with HA were enrolled in Haikou People's Hospital from June 2017 to June 2018. Throat swab specimens were collected and sent to CDC for real-time quantitative RT-PCR analysis of VP1 gene, and so detection of enteroviruses. The demographic data, clinical manifestations, and laboratory test results were also analyzed. Results A total of 14 genotypes of enteroviruses were detected in this study. Coxsackievirus A6(CVA6) was the most common pathogenic genotype of HFMD, and CVA2 was the major genotype causing HA. Specific genotypes of pathogenic enterovirus were associated with some possible clinical symptoms. Conclusions CVA6,CVA10 and CVA16 are the major pathogens of HFMD, while CVA2 is involved in most of the HA cases in children.
引文
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[8]张凤,史晓燕,苏志磊,等.2015年青岛地区手足口病主要病原谱及基因特征分析[J].中华微生物学和免疫学杂志,2017,37(12):903-909.
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[11]LAI C C,JIANG D S,WU H M,et al.A dynamic model for the outbreaks of hand,foot,and mouth disease in Taiwan[J].Epidemiol Infect,2016,144(7):1500-1511.
[12]LEE K Y,LEE M S,KIM D B.Neurologic manifestations of Enterovirus 71 infection in Korea[J].J Korean Med Sci,2016,31(4):561-567.
[2]MA Z,ZHA J.Characterization of VP1 gene of coxsackievirus A16 prevalent among hand foot mouth disease suffered children in Taizhou,P.R.China,between 2010 and 2013[J].J Med Virol,2016,88(2):202-210.
[3]YüKSEL S,EVRENGüL H,HAN B,e t a l.Onychomadesis-a late complication of hand-foot-mouth disease[J].J Pediatr,2016,174:274.
[4]LIU D P,WANG T A,HUANG W T,et al.Disease burden of enterovirus infection in Taiwan:Implications for vaccination policy[J].Vaccine,2016,34(7):974-980.
[5]GUAN H,WANG J,WANG C,et al.Etiology of multiple NonEV71 and Non-CVA16 enteroviruses associated with hand,foot and mouth disease in Jinan,China,2009-June 2013[J].PLoSOne,2015,10(11):e0142733.
[6]陈炜,翁育伟,何文祥,等.2011-2014年福建省手足口病相关病原柯萨奇病毒A组4型的分子流行病学分析[J].中国人兽共患病学报,2017,33(9):768-773.
[7]陈建华,武海卓,张勇,等.甘肃省2013-2015年手足口病流行特征及病原学分析[J].中华实验和临床病毒学杂志,2017,31(2):108-112.
[8]张凤,史晓燕,苏志磊,等.2015年青岛地区手足口病主要病原谱及基因特征分析[J].中华微生物学和免疫学杂志,2017,37(12):903-909.
[9]KOH W M,BOGICH T,SIEGEL K,et al.The epidemiology of hand,foot and mouth disease in Asia:a systematic review and analysis[J].Pediatr Infect Dis J,2016,35(10):e285-300.
[10]WANG M,REN Q,ZHANG Z,et al.Rapid detection of hand,foot and mouth disease enterovirus genotypes by multiplex PCR[J].J Virol Methods,2018,258:7-12.
[11]LAI C C,JIANG D S,WU H M,et al.A dynamic model for the outbreaks of hand,foot,and mouth disease in Taiwan[J].Epidemiol Infect,2016,144(7):1500-1511.
[12]LEE K Y,LEE M S,KIM D B.Neurologic manifestations of Enterovirus 71 infection in Korea[J].J Korean Med Sci,2016,31(4):561-567.