本文選題：手足口病　切入點：腸道病毒屬　出處：《中國全科醫(yī)學》2016年18期

【摘要】：目的對比分析腸道病毒71型(EV71)與柯薩奇A組16型(Cox A16)感染手足口病(HFMD)患兒的病毒載量及臨床特征。方法收集2015年5—9月唐山市婦幼保健院兒科確診的HFMD患兒430例,根據臨床癥狀、體征和病毒種類將患兒分為EV71輕度組162例、EV71重度組87例、Cox A16輕度組158例、Cox A16重度組23例。采用實時熒光定量反轉錄PCR技術檢測患兒咽拭子EV71、Cox A16 RNA,計算病毒載量;記錄患兒的病程、體溫、熱程、口腔潰瘍、流涎、咳嗽、手部出疹、足部出疹、嗜睡、驚厥、嘔吐、意識改變、肢體抖動、肌痙攣情況。結果標準曲線顯示循環(huán)閾值(Ct值)與病毒載量的對數呈高度負相關(r=-1.000,P0.01)。Ct值(X)與病毒載量的對數(Y)的關系為Y=-0.29X+13.03。Cox A16輕度組、Cox A16重度組HFMD患兒Ct值較EV71輕度組、EV71重度組降低(P0.05);EV71輕度組與EV71重度組、Cox A16輕度組與Cox A16重度組HFMD患兒Ct值比較,差異無統(tǒng)計學意義(P0.05)。EV71重度組、Cox A16重度組HFMD患兒病程較EV71輕度組、Cox A16輕度組延長(P0.05);EV71重度組HFMD患兒病程較Cox A16重度組延長(P0.05)。4組HFMD患兒體溫≥38.5℃、口腔潰瘍、流涎、手部出疹、足部出疹發(fā)生率比較,差異均無統(tǒng)計學意義(P0.05)。EV71重度組、Cox A16重度組HFMD患兒熱程≥3 d發(fā)生率較EV71輕度組、Cox A16輕度組升高(P0.007);EV71重度組、Cox A16重度組HFMD患兒體溫≥38.5℃+熱程≥3 d發(fā)生率較EV71輕度組、Cox A16輕度組升高,EV71輕度組HFMD患兒體溫≥38.5℃+熱程≥3 d發(fā)生率較Cox A16輕度組升高,EV71重度組HFMD患兒體溫≥38.5℃+熱程≥3 d發(fā)生率較Cox A16重度組升高(P0.007);Cox A16輕度組、Cox A16重度組HFMD患兒咳嗽、手部出疹數≥15個(雙手)、足部出疹數≥15個(雙足)發(fā)生率較EV71輕度組、EV71重度組升高(P0.007)。EV71重度組、Cox A16重度組HFMD患兒嗜睡、嘔吐發(fā)生率較EV71輕度組升高,EV71重度組HFMD患兒嗜睡發(fā)生率較Cox A16重度組升高(P0.01)。結論 HFMD患兒病毒載量與感染病毒相關,但不同病情程度間病毒載量無差別。不同病毒感染及病情程度患兒間熱程≥3 d、體溫≥38.5℃+熱程≥3 d、咳嗽、手部出疹數≥15個(雙手)、足部出疹數≥15個(雙足)、嗜睡、驚厥、嘔吐、意識改變、肢體抖動、肌陣攣發(fā)生率有差異。
[Abstract]:Objective to compare the viral load and clinical characteristics of children with HFMD infected by enterovirus 71 (EV71) and coxsackie group A (Coxsackie A). Methods 430 children with HFMD diagnosed in Tangshan Maternal and Child Health Hospital from May to September 2015 were collected according to their clinical symptoms. The children were divided into two groups: EV71 mild group (n = 162), severe group (n = 87), mild group (n = 158), severe group (n = 23). Real-time fluorescence quantitative reverse transcription (PCR) technique was used to detect the RNA of pharyngeal swab EV71 EV71 A16, and to calculate the viral load. The course of disease, body temperature, fever, oral ulcer, salivation, cough, hand rash, foot rash, somnolence, convulsion, vomiting, consciousness change, limb jitter were recorded. Myospasm. Results the standard curve showed that the circulating threshold value (Ct) was negatively correlated with the logarithm of viral load (P 0.01N. Ct) and the logarithm of viral load. The relationship between the value of Ct and the number of viral loads was that the Ct value of HFMD in severe 13.03.Cox A16 group was lighter than that in severe 13.03.Cox A16 group. The levels of HFMD Ct in patients with severe Cox A16 and severe Cox A16 were compared with those of mild group and severe group of EV71, and the value of HFMD was decreased in severe group of Cox A16 and mild group of EV71, compared with that of severe group of Cox A16. There was no significant difference in the course of disease of HFMD children in severe group P0.05N. EV71 compared with EV71 mild group. The course of disease in HFMD group was longer than that in Cox A16 group. The course of disease was more than 38.5 鈩，

本文編號：1695388