疱疹性咽峡炎患儿体内3种相关病毒检测及临床意义
|
摘要
目的检测疱疹性咽峡炎患儿体内肠道病毒(EV)、巨细胞病毒(CMV)和单纯疱疹病毒-1型(HSV-1)病毒核酸,并分析其临床意义。方法选取2014年3月—2015年8月唐山市妇幼保健院儿科就诊的疱疹性咽峡炎患儿394例,采用实时荧光PCR方法检测肠道病毒通用型(EV)、肠道病毒71型(EV71)、柯萨奇病毒A组16型(Cox A16)RNA以及CMV、HSV-1病毒DNA。结果检出EV71阳性83例,Cox A16阳性79例,其它EV阳性124例,EV总检出率为72.6%;CMV阳性87例;HSV-1阳性21例。EV71合并CMV阳性10例,Cox A16合并CMV阳性11例,其它EV合并CMV阳性21例;EV合并HSV-1阳性2例,HSV-1合并CMV阳性1例。合并CMV感染在EV71和Cox A16组间比较差异无统计学意义(P>0.05);CMV合并EV感染率高于HSV-1合并EV(P<0.01)。患儿中有69例发展成重症病例,其中单纯EV71阳性26例,单纯Cox A16阳性12例,其它EV阳性6例;单纯CMV阳性5例,单纯HSV-1阳性2例;EV71合并CMV阳性8例,Cox A16合并CMV阳性6例,其它EV合并CMV阳性4例。EV71感染重症率高于Cox A16感染(P<0.01),且Cox A16重症率高于其它EV病毒感染(P<0.05);单纯CMV和HSV-1感染重症率无统计学差异(P>0.05);合并感染重症病例的发生率均高于单个EV病毒感染(P<0.01)。结论 EV、CMV和HSV-1检测对疱疹性咽峡炎的诊断有重要意义;疱疹性咽峡炎也可出现重症病例,双重感染对病程发展有明显促进作用。
Objective To analyze the clinical significance of Enterovirus,Cytomegalovirus and HSV- 1 in children withherpangina by detecting virus nucleic acid. Methods A total of 394 cases of children with herpangina admitted to ourdepartment between March 2014 and August 2015,were selected as the observation group.Real- time fluorescent PCR wasemployed to test EV, EV71,Cox A16, CMV and HSV- 1. Results Eight- three cases were EV71 positive,79 cases wereCox A16 positive,other 124 cases were EV positive, EV overall detection rate was 72.6%; 87 cases were CMV positive,and 21 cases were HSV- 1 positive.There were 10 cases of double positive of EV71 and CMV,and 11 cases of double positive ofCox A16 and CMV.Other 21 cases of double positive of EV and CMV; 2 cases of double positive of EV and HSV- 1, 1 case ofdouble positive of HSV- 1 and CMV. There was no statistical significance of combination of CMV infection between the groupsEV71 and Cox A16(P>0.05);CMV companied with EV were higher infection ratio than HSV-1 companied with EV(P <0.01). Atotal of 26 cases were EV71 positive, 12 cases were Cox A16 positive, 5 cases were CMV positive, 2 cases were HSV-1 positiveand 6 cases were other EV positive in 69 cases of severe children.EV infection rate of severe was higher than Cox A16 and others(P <0.01),and Cox A16 severe rate were higher than other virus(P <0.05). Pure severe infection rate of CMV and HSV- 1 hadno statistical difference(P >0.05);The incidence of infection in severe medical records was higher than a single virus infection(P <0.01).Conclusion The detection of EV,CMV and HSV-1 in children with herpangina is an important role in diagnosis.The herpangina can appear severe medical records and the dual infection of illness have obvious promoting effect.
Objective To analyze the clinical significance of Enterovirus,Cytomegalovirus and HSV- 1 in children withherpangina by detecting virus nucleic acid. Methods A total of 394 cases of children with herpangina admitted to ourdepartment between March 2014 and August 2015,were selected as the observation group.Real- time fluorescent PCR wasemployed to test EV, EV71,Cox A16, CMV and HSV- 1. Results Eight- three cases were EV71 positive,79 cases wereCox A16 positive,other 124 cases were EV positive, EV overall detection rate was 72.6%; 87 cases were CMV positive,and 21 cases were HSV- 1 positive.There were 10 cases of double positive of EV71 and CMV,and 11 cases of double positive ofCox A16 and CMV.Other 21 cases of double positive of EV and CMV; 2 cases of double positive of EV and HSV- 1, 1 case ofdouble positive of HSV- 1 and CMV. There was no statistical significance of combination of CMV infection between the groupsEV71 and Cox A16(P>0.05);CMV companied with EV were higher infection ratio than HSV-1 companied with EV(P <0.01). Atotal of 26 cases were EV71 positive, 12 cases were Cox A16 positive, 5 cases were CMV positive, 2 cases were HSV-1 positiveand 6 cases were other EV positive in 69 cases of severe children.EV infection rate of severe was higher than Cox A16 and others(P <0.01),and Cox A16 severe rate were higher than other virus(P <0.05). Pure severe infection rate of CMV and HSV- 1 hadno statistical difference(P >0.05);The incidence of infection in severe medical records was higher than a single virus infection(P <0.01).Conclusion The detection of EV,CMV and HSV-1 in children with herpangina is an important role in diagnosis.The herpangina can appear severe medical records and the dual infection of illness have obvious promoting effect.
引文
[1]刘媛媛,李珊,李宁,等.儿科住院患者巨细胞病毒感染调查[J].华南国防医学杂志,2014,28(1):1-4.
[2]祝双利,刘建峰,孙强,等.单纯疱疹病毒1型引起的发热出疹性疾病需要与手足口病进行鉴别[J].病毒学报,2013,29(4):415-420.
[3]苏春杰.血清心肌酶、hs-CRP检测在手足口病患儿中的临床价值[J].中国热带医学,2014,14(6):728-730.
[4]胡亚美,江载芳,诸福堂.实用儿科学[M].7版,北京:人民卫生出版社,2005,54(1):11-16.
[5]Kwi Sung Park,Baeck Hee Lee,Kyoung Ah Baek,et al.Enteroviruses isolated from herpangina and hand-foot-and-mouth disease in Korean children[J].Virol J,2012,9:205.
[6]Jiratchaya Puenpa,John Mauleekoonphairoj,Piyada Linsuwanon,et al.Prevalence and Characterization of Enterovirus Infections among Pediatric Patients with Hand Foot Mouth Disease,Herpangina and Influenza Like Illness in Thailand,2012[J].PLo S One,2014,9(6):98888.
[7]阿不都热依木.阿不都克力木,高枫,陈薇,等.乌鲁木齐市2009~2013年手足口病流行病学分析[J].中国热带医学,2015,15(5):624-626.
[8]Tan CS,Frederico B,Stevenson PG.Herpesvirus delivery to the murine respiratory tract[J].J Virol Methods,2014,206:105-114.
[9]Lorne F Kastrukoff,Allen S Lau,Eva E Thomas.The effect of mouse strain on herpes simplex virus type 1(HSV-1)infection of the central nervous system(CNS)[J].Herpesviridae,2012,3:4.
[10]陈向前,施学文,曹青.手足口病流行期间疱疹性咽峡炎的病原及临床分析[J].临床儿科杂志,2013,31(5):429-432.
[11]苏明,倪祥文,李娟娟,等.保定市EV71和Cox A6、10、16型所致手足口病病原学分析[J].实用预防医学,2015,2(4):239-241.
[12]Eduardo Casaroto,Alexandre R Marra,Fernando Morgadinho S Coelho,et al.Improving the diagnosis of meningitis due to enterovirus and herpes simplex virus I and II in a tertiary care hospital[J].BMC Infect Dis,2013,13:487.
[2]祝双利,刘建峰,孙强,等.单纯疱疹病毒1型引起的发热出疹性疾病需要与手足口病进行鉴别[J].病毒学报,2013,29(4):415-420.
[3]苏春杰.血清心肌酶、hs-CRP检测在手足口病患儿中的临床价值[J].中国热带医学,2014,14(6):728-730.
[4]胡亚美,江载芳,诸福堂.实用儿科学[M].7版,北京:人民卫生出版社,2005,54(1):11-16.
[5]Kwi Sung Park,Baeck Hee Lee,Kyoung Ah Baek,et al.Enteroviruses isolated from herpangina and hand-foot-and-mouth disease in Korean children[J].Virol J,2012,9:205.
[6]Jiratchaya Puenpa,John Mauleekoonphairoj,Piyada Linsuwanon,et al.Prevalence and Characterization of Enterovirus Infections among Pediatric Patients with Hand Foot Mouth Disease,Herpangina and Influenza Like Illness in Thailand,2012[J].PLo S One,2014,9(6):98888.
[7]阿不都热依木.阿不都克力木,高枫,陈薇,等.乌鲁木齐市2009~2013年手足口病流行病学分析[J].中国热带医学,2015,15(5):624-626.
[8]Tan CS,Frederico B,Stevenson PG.Herpesvirus delivery to the murine respiratory tract[J].J Virol Methods,2014,206:105-114.
[9]Lorne F Kastrukoff,Allen S Lau,Eva E Thomas.The effect of mouse strain on herpes simplex virus type 1(HSV-1)infection of the central nervous system(CNS)[J].Herpesviridae,2012,3:4.
[10]陈向前,施学文,曹青.手足口病流行期间疱疹性咽峡炎的病原及临床分析[J].临床儿科杂志,2013,31(5):429-432.
[11]苏明,倪祥文,李娟娟,等.保定市EV71和Cox A6、10、16型所致手足口病病原学分析[J].实用预防医学,2015,2(4):239-241.
[12]Eduardo Casaroto,Alexandre R Marra,Fernando Morgadinho S Coelho,et al.Improving the diagnosis of meningitis due to enterovirus and herpes simplex virus I and II in a tertiary care hospital[J].BMC Infect Dis,2013,13:487.