摘要
目的回顾性分析柯萨奇病毒A组6型(coxsackievirus A6,CV-A6)感染在不同年龄组手足口病(hand,foot and mouth disease,HFMD)的临床特点。方法对2015年1月—2017年12月疑似或临床诊断为HFMD的患儿留取咽拭子标本,采用实时荧光定量聚合酶链反应(Real-Time PCR)方法检测标本中肠道病毒核酸,将CV-A6阳性病例按年龄进行分组比较。结果467例CV-A6阳性HFMD病例,年龄3月~16岁,婴幼儿组(≤3岁)273例,学龄前期组(3~6岁)131例,学龄期组(>6岁)63例,5~11月份为发病高峰;发热为常见症状,其中婴幼儿组发热发生率最高(220/273,80.5%);婴幼儿组白细胞升高比例最高(127/273,46.5%),高于学龄期组(17/63,27.0%),组间比较存在统计学意义;CV-A6所致HFMD皮疹形态多样,婴幼儿组皮疹多形性比例最高(163/273,59.7%);学龄期组分布部位数最少(0.89±0.86);婴幼儿组肘关节(109/273,39.9%)、膝部(88/273,32.6%)、大腿(112/273,41%)、臀部(122/273,44.7%)皮疹发生率高于其他两组,学龄期组前臂(0/63,0%)、足心(41/63,65.1%)、小腿(0/63,0%)、大腿(6/63,9.5%)皮疹发生率低于其他两组,组间比较差异均存在统计学意义;全部病例均临床痊愈,无重症病例发生,发病6个月后共有288例接受随访,其中33例发生甲脱落(33/288,11.5%)。结论不同年龄组CV-A6所致HFMD临床表现存在差异,婴幼儿组更常出现发热症状,皮疹分布范围更广,皮疹形态更具多形性,血常规白细胞升高更为多见。
Objective To analyze the clinical characteristics of hand,foot and mouth disease(HFMD)caused by coxsackievirus A6(CV-A6)in different age groups.Methods From January 2015 to December 2017,throat swabs were collected from children with or suspected of having HFMD then quantitative real-time PCR was performed to detect enterovirus nucleic acid.HFMD cases caused by CV-A6 were divided into different groups according to age for comparison.Results In total,there were 467 cases of HFMD caused by CV-A6 with the age ranging from 3 months to 16 years.There were 273 cases in the infants and young children group(<3 years old),131 cases in the pre-school group(3-6 years old),and 63 cases in the school-age group(>6 years old).The peak incidence was found between May and November.Fever was the common symptom,and the rate of fever in infant group was the highest(220/273,80.5%);The proportion of cases with leucocyte elevation in the infant group was the highest(127/273,46.5%)than that in the school-age group(17/63,27.0%)with a statistical significance.The skin erythra of the HFMD caused by CV-A6 were diverse in forms.Over two forms of skin erythra accounted for 53.9%(257/476)of all cases,and the cases in the infant group showing more forms of skin erythra(163/273,59.7%).The oral herpes were mainly distributed in the upper palate and pharyngeal isthmus,but the school age group had the least number of distribution sites(0.89±0.86).The cases in the infant group showed higher incidence of skin rash at the elbow joint(109/273,39.9%),knee(88/273,32.6%),thigh(112/273,41%),buttock(122/273,44.7%)than the other two groups,However,the school age group showed lower incidence of skin rash in the lower leg(0/63,0%)and thigh(6/63,9.5%)than the other two groups.The differences between groups were statistically significant.All cases were cured clinically,no severe cases occurred.Among the 288 cases followed up for 6 months,33(33/288,11.5%)suffered from nail exfoliation.Conclusions Different age groups of HFMD caused by CV-A6 had different clinical manifestations.In the infant group,more cases had fever and the erythra were more diverse in forms and wider in distribution.In addition,the increased leukocytes in routine blood test was also more common in the infant group.
作者
张楠
黄辉
贾立平
于方圆
金凤华
郑崇光
周丽君
吴婷婷
张榕
邓莉
Zhang Nan;Huang Hui;Jia Liping;Yu Fangyuan;Jin Fenghua;Zheng Chongguang;Zhou Lijun;Wu Tingting;Zhang Rong;Deng Li(Department of Infections Diseases,Capital Institute of Pediatrics Affiliated Children Hospital,Beijing 100020,China;Laboralory of Virology,Beijing Key Laboratory of Etiology of Viral Diseases in Children,Capital Institute of Pediatrics,Beijing 100020,China)
出处
《中华实验和临床病毒学杂志》
CAS
CSCD
2019年第5期495-499,共5页
Chinese Journal of Experimental and Clinical Virology
关键词
柯萨奇病毒A6
手足口病
年龄
临床表现
Coxsackievirus A6
Hand
foot and mouth disease
Age
Clinical manifestations
作者简介
通信作者:黄辉,Email:huihui07@tom.com,电话:010-85695356。
