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目的了解2013年北京市昌平区手足口病(HFMD)的病原构成及临床特征。方法用描述流行病学方法对HFMD患者的调查问卷和检测结果进行分析。结果采集98例患者咽拭子,病原学检测47件样品阳性,其中CoxA6阳性占44.68%(21/47),EV71和CoxA16阳性占46.81%(22/47),患者临床表现有发热、皮疹/疱疹、脱甲症、脱皮现象、色素沉着、呼吸道症状、消化道症状,CoxA6阳性患者中发热38℃以上的比例为76.19%(16/21),高于非CoxA6病例(χ2=10.58,P<0.01);CoxA6阳性患者脱甲发生率为28.57%(6/21),高于非CoxA6病例(χ2=18.73,P<0.01);CoxA6阳性患者脱皮发生率为66.67%(14/21),亦高于非CoxA6病例(χ2=49.46,P<0.01)。结论昌平区HFMD的病原构成变化较大,CoxA6逐步成为HFMD优势株;临床特征除呼吸道症状、消化道症状外,出现了特征性的脱甲症、脱皮现象和色素沉着,发热38℃以上患者比例增加。
Objective To understand the etiopathogenisis and clinical features of hand-foot-mouth disease (HFMD) in Changping District in Beijing in 2013. Methods Descriptive epidemiological methods were used to analyze the questionnaire and test results of patients with HFMD. Results Throat swabs were collected in 98 patients. The etiological detection of 47 samples was positive, of which CoxA6 positive accounted for 44.68% (21/47), EV71 and CoxA16 positive accounted for 46.81% (22/47), clinical manifestations of fever, rash / Herpes, demethylation, peeling, pigmentation, respiratory symptoms and gastrointestinal symptoms were higher in CoxA6 positive patients than in non-CoxA6 patients (χ2 = 10.58, P < 0.01). The incidence of dementia in CoxA6 positive patients was 28.57% (6/21), higher than that in non-CoxA6 patients (χ2 = 18.73, P <0.01). The incidence of peeling in CoxA6 positive patients was 66.67% (14/21) Higher than non-CoxA6 cases (χ2 = 49.46, P <0.01). CONCLUSION: The pathogenic composition of HFMD in Changping District changed greatly. CoxA6 gradually became the predominant strain of HFMD. Clinical features included symptoms of demethylation, peeling and hyperpigmentation. Except for respiratory symptoms and gastrointestinal symptoms, the proportion of patients with fever over 38 ℃ increase.