【摘要】：腸道病毒71型（Enterovirus71，EV71）是手足口病（hand,foot and mouthdisease,HFMD）的主要病原體之一。近期，在亞洲兒童中，EV71已經引起了危及生命的大爆發(fā)流行，主要累及神經和心肺系統(tǒng)，但具體機制至今仍不明確。EV7l感染可導致全球性流行，四季均可致病，以夏秋季為發(fā)病高峰，潛伏期2～10天，平均3～5天。傳染源包括患者、隱性感染者及健康帶毒者。EV71主要通過消化道、呼吸道及直接接觸患者鼻喉分泌液、唾液、水皰液、糞便等途徑傳播。此病多發(fā)生于5歲以內兒童，尤其是3歲以內嬰幼兒，以手、足、臀部位皮膚及口腔粘膜的皰疹為典型表現，起病時多有發(fā)熱，伴有咽部疼痛，大多數預后良好，少數病例可出現致命的神經系統(tǒng)、呼吸系統(tǒng)及循環(huán)系統(tǒng)并發(fā)癥，如無菌性腦膜炎、脊髓灰質炎樣麻痹、病毒性腦炎、神經源性肺水腫（neurogenic pulmonaryedema,NPE）及心肌炎。 EV71是目前最具有嗜神經性的腸道病毒（Enterovirus，EV），EV71感染最嚴重的并發(fā)癥是NPE，NPE病程進展迅速、治療困難、病死率高，對我國兒童健康造成了嚴重危害，由EV71感染所導致的NPE近年來受到人們的廣泛關注，雖然臨床報道很多，但其發(fā)病機制目前尚不十分清楚，另外，目前還沒研制出相應的疫苗或抗病毒藥物用于EV71引起的疾病的預防和治療，因此，，針對EV71的基礎研究對目前HFMD高發(fā)態(tài)勢下的公共衛(wèi)生形勢來說顯得十分迫切和意義重大。故本文通過對EV71的流行病學、病原學，EV71致NPE的發(fā)病機制、診斷、鑒別診斷及治療作一系統(tǒng)論述，為EV71致NPE的研究提供參考。
[Abstract]:Enterovirus 71 (Enterovirus71,EV71) is one of the main pathogens of hand, foot and mouth disease (hand,foot and mouthdisease,HFMD). Recently, among Asian children, EV71 has caused a life-threatening outbreak, mainly involving the nervous and cardio-pulmonary system, but the specific mechanism is still unclear. EV 7l infection can lead to a global epidemic, and can cause disease throughout the four seasons. The peak of onset was summer and autumn, and the incubation period was 2-10 days (average 3-5 days). EV71 is mainly transmitted through digestive tract, respiratory tract and direct contact with nasal and laryngeal secretions, saliva, vesicular fluid, feces and so on. The disease usually occurs in children under 5 years of age, especially infants under 3 years of age. The typical manifestation of this disease is herpes in the skin and oral mucosa of the hands, feet, buttocks, and oral mucosa. Most of them have fever and sore pharynx when they start the disease, and most of them have a good prognosis. Fatal neurological, respiratory and circulatory complications such as aseptic meningitis, poliomyelitis, viral encephalitis, neurogenic pulmonary edema (neurogenic pulmonaryedema,NPE) and myocarditis can occur in a few cases. EV71 is the most neurotropic enterovirus (Enterovirus,EV) at present. The most serious complication of EV71 infection is the rapid progress of the course of disease, the difficulty of treatment and the high mortality of NPE,NPE, which has caused serious harm to the health of children in China. NPE, caused by EV71 infection, has received extensive attention in recent years. Although many clinical reports have been reported, the pathogenesis of NPE is still unclear. In addition, At present, the corresponding vaccines or antiviral drugs have not been developed for the prevention and treatment of EV71-induced diseases. Therefore, the basic research on EV71 is very urgent and significant to the public health situation under the situation of high incidence of HFMD. In this paper, the epidemiology, etiology, pathogenesis, diagnosis, differential diagnosis and treatment of EV71-induced NPE were systematically discussed in order to provide a reference for the study of EV71-induced NPE.
【學位授予單位】：蚌埠醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R725.1

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