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目的对2010～2012年德州市11县市区1 739例手足口病病例进行病原谱分析。方法采用荧光定量PCR方法对手足口病病例粪便标本进行肠道病毒通用型、EV71型和Cox A16型核酸检测。结果 1 739例手足口病病例肠道病毒通用型核酸阳性率64.29%,其中EV71阳性率为25.24%,Cox A16阳性率为22.31%,其他肠道病毒阳性率为16.73%;2010年病原以Cox A16为主,2011年病原以EV71为主,2012年病原以Cox A16为主,且有其他待定型别肠道病毒流行,检出率高于Cox A16;不同县市区之间病原体类型的阳性率差异有统计学意义(χ2=308.629,P<0.01);2～3岁组发病率最高,<1岁组病例数最少;发病时间主要集中在每年的4～7月,5月份病例数最多;9例重症病例中6例由EV71引起,1例由Cox A16引起,其他2例肠道病毒检测为阴性。结论手足口病病原谱复杂,具有动态变化特征。应加强手足口病监测,在发病高峰到来之前提前做好各项防控工作。
Objective To analyze the pathogen spectrum of 1 739 cases of HFMD in 11 counties of Dezhou from 2010 to 2012. Methods Fluorescent quantitative PCR was used to detect enterovirus universal, EV71 and Cox A16 nucleic acid in stool samples of hand foot and mouth disease. Results The prevalence of enterovirus universal nucleic acid in 1739 cases of HFMD was 64.29%, of which the positive rate of EV71 was 25.24%, the positive rate of Cox A16 was 22.31% and the positive rate of other enterovirus was 16.73% A16 mainly in 2011 EV71-based pathogens in 2012 Cox A16-based pathogens, and there are other types of undetermined intestine virus prevalence, the detection rate was higher than Cox A16; positive in different counties between the types of pathogens The difference was statistically significant (χ2 = 308.629, P <0.01). The morbidity was the highest in 2 ~ 3 years old group and the lowest in <1 years old group. The onset time was mainly in April ~ July each year, with the highest number in May 6 of 9 severe cases were caused by EV71, 1 was caused by Cox A16, and the other 2 cases of enterovirus were negative. Conclusion HFMD spectrum is complicated and has dynamic characteristics. Hand-foot-mouth disease monitoring should be strengthened to prevent and control various diseases ahead of the peak incidence.