阜阳市2011年手足口病实验室检测结果分析

doi:10.3969/j.issn.1673-8640.2013.09.015

检验医学 ›› 2013, Vol. 28 ›› Issue (9): 796-800.DOI: 10.3969/j.issn.1673-8640.2013.09.015

阜阳市2011年手足口病实验室检测结果分析

高勇^¹,韩明锋^²,李秀勇^³,陈晓枫^⁴,唐振华^¹

1.阜阳市第二人民医院检验科,安徽阜阳 236015;
2.阜阳市第二人民医院呼吸科,安徽阜阳 236015;
3.阜阳市第二人民医院肾病科,安徽阜阳 236015;
4.阜阳市第二人民医院应急1科,安徽阜阳 236015

收稿日期:2012-10-25 修回日期:2013-09-25 出版日期:2013-09-15 发布日期:2013-09-25
作者简介:高勇,1974年生,学士,副主任技师,主要从事生化及分子生物学检验工作。
基金资助:
阜阳市卫生局医学科研课题(201125)

Analysis on the laboratory determination results of hand-foot-mouth disease in Fuyang in 2011

GAO Yong^¹,HAN Mingfeng^²,LI Xiuyong^³, CHEN Xiaofeng^⁴, TANG Zhenhua^¹.

1. Department of Clinical Laboratory, the Second People′s Hospital of Fuyang, Anhui Fuyang 236015, China;
2.Department of Respiration, the Second People′s Hospital of Fuyang, Anhui Fuyang 236015, China;
3. Department of Nephrology, the Second People′s Hospital of Fuyang, Anhui Fuyang 236015, China;
4.Department of Emergency I, the Second People′s Hospital of Fuyang, Anhui Fuyang 236015, China

Received:2012-10-25 Revised:2013-09-25 Online:2013-09-15 Published:2013-09-25

摘要/Abstract

摘要：

目的对手足口病患儿的实验室检测结果进行分析,了解阜阳市手足口病患儿肠道病毒的感染状况及实验室常规检验项目的检测结果,为临床诊断治疗及预防控制提供参考。方法收集497例(重症型102例、普通型395例)手足口病住院患儿的咽试子和疱疹液样本,应用实时荧光聚合酶链反应 (RT-PCR)法检测肠道病毒通用型(EV)、肠道病毒71型(EV71)以及柯萨奇病毒A组16型(CA16) 特异性RNA。同时检测白细胞(WBC)、C反应蛋白(CRP)、肌酸激酶同工酶(CK-MB) 、天门冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LDH)及血糖(Glu)并进行分析。结果 497例手足口病患儿中EV、EV71、CA16感染的阳性例数(阳性率)分别为339例(68.21%)、286例(57.55%)、22例(4.43%)。102例重症手足口病患儿中EV71阳性率最高[95例(93.14%)];男、女性患儿间EV、EV71、CA16阳性率差异无统计学意义(P>0.05)。3岁以下患儿为高风险年龄组,497例手足口病患儿中有398例(80.08%)≤3岁。102例重症型患儿有96例(94.12%)≤3岁;其中EV71阳性率最高,为94.79%(91/96)。重症手足口病患儿中WBC增高80例(78.43%)、CRP增高81例(79.41%)、Glu增高52例(50.98%)、AST增高64例(62.75%);普通型患儿WBC增高70例(17.72%)、CRP增高87例(22.03%)、Glu增高26例(6.58%)、AST增高78例(19.75%);重症型阳性率明显高于普通型(P<0.01)。CK-MB、LDH水平在手足口病普通型及重症型患儿中均增高,且阳性率明显高于其他常规检验项目。结论手足口病患儿感染的肠道病毒主要为EV71病毒,而且是引起重症型病例的主要病原体,3岁以下婴幼儿应加强监测。对重症型病例应做到早期识别,减少重症和死亡的发生。

关键词: 手足口病, 逆转录聚合酶链反应, 肠道病毒, 柯萨奇病毒

Abstract:

Objective To analyze the laboratory determination results of hand-foot-mouth disease to reveal the enterovirus infection and the results of routine determination items in children with hand-foot-mouth disease at Fuyang, and to provide the reference for diagnosis, treatment, prevention and control. Methods Both throat swab and vesicle fluid were collected from 497 children with hand-foot-mouth disease (severe case: 102 cases and common case: 395 cases). Specific RNA of enterovirus primer (EV), enterovirus 71 (EV71) and coxsackievirus A16(CA16)were detected by real-time fluorescence polymerase chain reaction (RT-PCR). Simultaneously, white blood cell (WBC),C reactive protein(CRP),creatine kinase MB isoenzyme(CK-MB), aspartate aminotransferase (AST),lactic dehydrogenase (LDH) and glucose (Glu) were determined, and the results were analyzed. Results Among the 497 children, 339 cases were positive for EV, 286 cases were positive for EV71, and only 22 cases were positive for CA16.The positive rates were 68.21%, 57.55% and 4.43%, respectively. In the 102 hand-foot-mouth disease severe cases,EV71 positive rate was the highest(95 cases, 93.14%). There was no statistical significance in EV, EV71 and CA16 positive rates between boys and girls (P> 0.05).The age distribution was mainly in the group under 3-year-old (398 cases, 80.08%). In the group under 3-year-old, there were 96 severe cases (94.12%), and the EV71 positive rate was the highest (94.79%, 91/96). The increasing cases of WBC was 80 cases (78.43%),CRP 81 cases (79.41%),Glu 52 cases (50.98%) and AST 64 cases (62.75%) in the severe cases of hand-foot-mouth disease. In the common cases, the increasing cases of WBC was 70 cases (17.72%),CRP 87 cases (22.03%),Glu 26 cases (6.58%) and AST 78 cases (19.75%). The positive rates in the severe cases were higher than those in the common cases (P<0.01). The levels of CK-MB and LDH increased in the common and severe cases of hand-foot-mouth disease,and the positive rates of CK-MB and LDH were obviously higher than the other routine determination items. Conclusions The hand-foot-mouth disease appeared in Fuyang in 2011 is mainly related to the EV71 infection, and EV71 is the main pathogen causing the severe cases of hand-foot-mouth disease. The monitoring should be strengthened especially in the group under 3-year-old. The severe cases should be early recognized in order to reduce the occurrence of the severe cases and the death.

Key words: Hand-foot-mouth disease, Reverse transcription polymerase chain reaction, Enterovirus, Coxsackievirus

中图分类号:

R725.1

高勇,韩明锋,李秀勇,陈晓枫,唐振华. 阜阳市2011年手足口病实验室检测结果分析[J]. 检验医学, 2013, 28(9): 796-800.

GAO Yong,HAN Mingfeng,LI Xiuyong, CHEN Xiaofeng, TANG Zhenhua.. Analysis on the laboratory determination results of hand-foot-mouth disease in Fuyang in 2011[J]. , 2013, 28(9): 796-800.

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阜阳市2011年手足口病实验室检测结果分析

Analysis on the laboratory determination results of hand-foot-mouth disease in Fuyang in 2011

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