本文選題：手足口病　切入點(diǎn)：腸道病毒型　出處：《復(fù)旦學(xué)報(bào)(醫(yī)學(xué)版)》2017年05期 　論文類型：期刊論文

【摘要】：目的對(duì)2009—2016年上海市手足口病(hand,foot and mouth disease,HFMD)哨點(diǎn)醫(yī)院——復(fù)旦大學(xué)附屬兒科醫(yī)院及閔行區(qū)轄區(qū)社區(qū)衛(wèi)生服務(wù)中心送檢的手足口病病例標(biāo)本進(jìn)行實(shí)驗(yàn)室檢測(cè)分析,探討手足口病在本地區(qū)的病原學(xué)構(gòu)成及流行病學(xué)特征,為手足口病的綜合防治提供依據(jù)。方法收集2009—2016年復(fù)旦大學(xué)附屬兒科醫(yī)院及社區(qū)衛(wèi)生服務(wù)中心送檢的手足口病病例咽拭、糞便、肛拭標(biāo)本,應(yīng)用real-time RT-PCR技術(shù)檢測(cè)腸道病毒通用型(Echo viruses,EV)、腸道病毒71型(EV71)、柯薩奇病毒A組16型(Coxsackie virus A16,CVA16)、柯薩奇病毒A組6型(CVA6)、柯薩奇病毒A組10型(CVA10),并分析病原體分布特征。結(jié)果共收集到手足口病病例3 744例,病原學(xué)檢測(cè)發(fā)現(xiàn)3 176例腸道病毒檢測(cè)陽(yáng)性,陽(yáng)性檢出率高達(dá)84.83%。其中EV71和CVA16分別占64.45%和15.77%,其次是CVA6和其他腸道病毒,分別占9.23%和8.78%,CVA10檢出率僅0.76%,主要病原體為EV71病毒。不同年份和不同季節(jié)的優(yōu)勢(shì)毒株呈現(xiàn)動(dòng)態(tài)變化;2009年以EV71和CVA16共同流行為主;2010—2011年以EV71流行為主;2012年呈現(xiàn)EV71和CVA16共同流行趨勢(shì),以EV71為主;2013年以EV71和其他EV共同流行為主;2014年之后CVA6逐漸增多,至2015和2016年主要以CVA6流行為主;特別是2016年,CVA6所占比例范圍高達(dá)40.55%。CVA10呈零星散發(fā)趨勢(shì),占比極低。病例人群男性高于女性(1.68∶1),主要發(fā)病年齡為5歲以下的嬰幼兒,病例集中在1~3歲低幼年齡組,手足口病發(fā)病高峰主要集中在4~7月,其次是9~11月。結(jié)論手足口病主要發(fā)病季節(jié)呈現(xiàn)夏季和秋冬季的雙峰流行模式;多發(fā)于5歲以下兒童;男性發(fā)病率高于女性;不同年份和不同季節(jié)的優(yōu)勢(shì)毒株呈現(xiàn)動(dòng)態(tài)變化,其流行具有明顯的年齡和季節(jié)性特征。
[Abstract]:Objective to detect and analyze the hand foot and mouth disease (HFMD) case samples from Shanghai Hand-foot and mouth Disease Sentinel Hospital, affiliated Pediatrics Hospital of Fudan University and the Community Health Service Center of Minhang District from 2009 to 2016. To explore the etiological composition and epidemiological characteristics of HFMD in this area, and to provide the basis for the comprehensive prevention and treatment of HFMD. Methods the pharyngeal swabs of HFMD cases from 2009 to 2016 were collected from Pediatrics Hospital and Community Health Service Center of Fudan University. Faeces, anal swabs, Real-time RT-PCR technique was used to detect enterovirus Echo virus EVN, enterovirus 71 EV71, Coxsackie virus A16, Coxsackie virus A16, Coxsackie virus A16, Coxsackie A 6, Coxsackie virus A 6, Coxsackie virus A 10 CVA10 and to analyze the distribution of pathogens. 3,744 cases of hand, foot and mouth disease were collected, Pathogenic examination showed that 3 176 cases of enterovirus were positive, the positive rate was as high as 84.83%, of which EV71 and CVA16 accounted for 64.45% and 15.77 respectively, followed by CVA6 and other enterovirus. The positive rate of CVA10 was only 0.76% in 9.23% and 8.78%, respectively. The main pathogen was EV71 virus. The dominant strains in different years and seasons showed dynamic changes; in 2009, the common epidemic of EV71 and CVA16 was mainly EV71 in 2010-2011; in 2012, EV71 and CVA16 were the same epidemic trend. In 2013, EV71 and other EV were the main epidemic. After 2014, the prevalence of CVA6 increased gradually, and by 2015 and 2016, the prevalence of CVA6 was mainly CVA6. Especially, the proportion of CVA6 was as high as 40.55%. CVA10 showed sporadic tendency. The incidence of HFMD in male was higher than that in female (1.68: 1). The incidence of HFMD was mainly in the age group of primary-age aged 1 ~ 3 years. The incidence peak of HFMD was mainly from 4 to July, and the incidence of HFMD was mainly in the age group of 1 ~ 3 years old. Conclusion the prevalence pattern of HFMD in summer and autumn and winter is more than that in children under 5 years of age, the incidence of HFMD in males is higher than that in females, and the dominant strains of HFMD in different years and seasons show dynamic changes. Its prevalence has obvious age and seasonal characteristics.
【作者單位】： 上海市閔行區(qū)疾病預(yù)防控制中心;
【基金】：上海市第四輪公共衛(wèi)生三年行動(dòng)計(jì)劃高端海外研修團(tuán)隊(duì)計(jì)劃(GWTD2015S05) 上海市研究生教育創(chuàng)新計(jì)劃~~
【分類號(hào)】：R181.3;R512.5
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本文編號(hào)：1618526