2010-2018年六安市手足口病病原学特征分析

杨卫; 李修德; 常宏伟

doi:10.16462/j.cnki.zhjbkz.2021.03.022

2010-2018年六安市手足口病病原学特征分析

doi: 10.16462/j.cnki.zhjbkz.2021.03.022

237000 六安，六安市疾病预防控制中心微生物检验科

基金项目:

安徽省预防医学与公共卫生科研课题 2011Y0111

详细信息

通讯作者:
常宏伟，E-mail: 984368706@qq.com

中图分类号: R183.4
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出版历程
- 收稿日期: 2020-05-25
- 修回日期: 2020-07-01
- 刊出日期: 2021-03-10

Analysis of etiological characteristics of hand-foot-mouth disease (HFMD) in Lu'an City from 2010 to 2018

Microbiological Laboratory, Lu'an Municipal Center for Disease Control and Prevention, Lu'an 237000, China

Funds:

Research Project of Preventive Medicine and Public Health in Anhui Province 2011Y0111

More Information

Corresponding author: CHANG Hong-wei, E-mail: 984368706@qq.com

摘要

摘要: 目的分析2010-2018年六安市手足口病病原学特征，为手足口病的防控提供科学依据。方法收集2010-2018年六安市各县区手足口病临床诊断病例咽拭子样本，采用实时荧光定量PCR技术进行肠道病毒核酸检测，并对检测结果进行分析。结果在采集的2 360份手足口病临床诊断病例咽拭子样本中，肠道病毒核酸检测阳性的有1 085份(45.97%)，其中肠道病毒71型(Enterovirus 71, EV71) 382份(35.21%)，柯萨奇病毒A16型(Coxsackievirus A16, COXA16)334份(30.78%)，柯萨奇病毒A6型(Coxsackievirus A6, COXA6)169份(15.58%)，柯萨奇病毒A10型(Coxsackievirus A10, COXA10)15份(1.38%), 其他肠道病毒185份(17.05%)。2010-2014年及2016年EV71为优势流行株(χ²=188.555, P < 0.001)，2015年和2017年以COXA6成为优势流行株(χ²=258.732, P < 0.001)。从检测结果看，不同县区阳性率存在统计学差异(χ²=68.879, P < 0.001)，以叶集区最高(81.25%, 52/64)，霍邱县最低(30.41%, 52/171)。1~3岁年龄组患病人数居高，占各年龄组总阳性数的68.11%(739/1 085)。1 085例阳性病例中男性705例，女性380例，但是阳性检出率无性别差异(χ²=1.354, P=0.245)。结论六安市手足口病病原为多型别共存，每年的优势毒株均发生变化，年龄、地域和性别等因素均可影响手足口病的流行，加强手足口病的监测，有利于该病的防控。
- 手足口病 /
- 肠道病毒 /
- 病原学
Abstract: Objective The etiogical characteristics of hand-foot-mouth disease (HFMD) in Lu'an City from 2010 to 2018 were analyzed to provide basis for the prevention and control of HFMD. Methods Pharyngeal swabs were collected from clinical-diagnosis-case of HFMD in all counties and districts of Lu'an City from 2010 to 2018. Quantitative real-time PCR was used to detect Enterovirus nucleic acid, and the detection results were analyzed. Results Among the 2 360 pharyngeal swabs collected from clinical-diagnosis-case of HFMD, 1 085 (45.97%) were positive from Enterovirus. There were 382 (35.21%) of Enterovirus 71 (EV71), 334 (30.78%) of Coxsackievirus A16 (COXA16), 169 (15.58%) of Coxsackievirus A6 (COXA6), 15 (1.38%) of Coxsackievirus A10 (COXA10), and 185 (17.05%) of other Enteroviruses. EV71 was the dominant strain from 2010 to 2014 and 2016 (χ²=188.555, P < 0.001), and COXA6 was the dominant strain in 2015 and 2017 (χ²=258.732, P < 0.001). The positive rate was significantly different in different counties (χ²=68.879, P < 0.001), with the highest rate in Yeji District (81.25%, 52/64), and the lowest rate in Huoqiu County (30.41%, 52/171). The number of patients in 1-3-year-old group was the highest, accounting for 68.11% (739/1 085) of the total positive cases in each age group. Among the 1 085 positive cases, 705 were male and 380 were female, but there was no statistical difference in the positive detection rate (χ²=1.354, P=0.245). Conclusions There are various types of HFMD pathogens in Lu'an City, and the dominant strains change every year. Factors such as season, age, region and gender can affect the prevalence of HFMD. Strengthening the monitoring of HFMD pathogen is helpful to prevent and control HFMD.
- Hand-foot-mouth disease (HFMD) /
- Enterovirus /
- Etiology

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表 1 2010-2018年六安市手足口病病原检测结果[n(%)]

Table 1. Pathogen detection results of HFMD in Lu'an City from 2010 to 2018 [n(%)]

年份(年)	标本数	病毒阳性数	EV71	COXA16	COXA6	COXA10	其他EV
2010	232	117(50.43)	74(63.25)	41(35.04)	0(0.00)	2(1.71)	0(0.00)
2011	283	160(56.54)	71(44.38)	51(31.88)	0(0.00)	0(0.00)	38(23.75)
2012	268	130(48.51)	81(62.31)	27(20.77)	6(4.62)	0(0.00)	16(12.31)
2013	155	49(31.61)	19(38.78)	4(8.16)	1(2.04)	2(4.08)	23(46.94)
2014	279	107(38.35)	53(49.53)	22(20.56)	1(0.93)	0(0.00)	31(28.97)
2015	296	130(43.92)	27(20.77)	31(23.85)	40(30.77)	2(1.54)	30(23.08)
2016	319	101(31.66)	45(44.55)	17(16.83)	10 (9.90)	0(0.00)	29(28.71)
2017	69	24(34.78)	3(12.5)	8(33.33)	12(50.00)	1(4.17)	0(0.00)
2018	459	267(58.17)	9(3.37)	133(49.81)	99(37.08)	8(3.00)	18(6.74)
合计	2 360	1 085(45.97)	382(35.21)	334(30.78)	169(15.58)	15(1.38)	185(17.05)
χ²值		92.438	237.781	81.832	228.054	14.633^a	110.942
P值		< 0.001	< 0.001	< 0.001	< 0.001	0.018^a	< 0.001
注：^a表示采用Fisher确切概率法。

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表 2 2010-2018年六安市不同县区肠道病毒分布[n(%)]

Table 2. Distribution of Enterovirus nucleic acid in different counties in Lu'an City from 2010 to 2018 [n(%)]

地区	标本数	病毒阳性数	EV71	COXA16	COXA6	COXA10	其他EV
金安区	467	204(43.68)	71(34.80)	78(38.24)	28(13.73)	3(1.47)	24(11.76)
裕安区	342	153(44.74)	57(37.25)	68(44.44)	9(5.88)	1(0.65)	18(11.76)
霍邱县	171	52(30.41)	7(13.46)	7(13.46)	27(51.92)	0(0.00)	11(21.15)
霍山县	233	129(55.36)	42(32.56)	47(36.43)	25(19.38)	1(0.78)	14(10.85)
金寨县	505	207(40.99)	69(33.33)	60(28.99)	28(13.53)	1(0.48)	49(23.67)
舒城县	196	106(54.08)	34(32.08)	24(22.64)	23(21.70)	2(1.89)	23(21.70)
叶集区	64	52(81.25)	6(11.54)	8(15.38)	23(44.23)	3(5.77)	12(23.08)
寿县	382	182(47.64)	96(52.75)	42(23.08)	6(3.30)	4(2.20)	34(18.68)
合计	2 360	1 085(45.97)	382(35.21)	334(30.78)	169(15.58)	15(1.38)	185(17.05)
χ²值		68.879	49.562	42.445	122.146	8.360^a	20.887
P值		< 0.001	< 0.001	< 0.001	< 0.001	0.195^a	0.004
注：^a表示采用Fisher确切概率法。

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表 3 2010-2018年六安市不同年龄组肠道病毒核酸阳性分布[n(%)]

Table 3. Comparison of nucleic acid positive rates of Enteroviruses in different age groups in Lu'an City from 2010 to 2018 [n(%)]

年龄(岁)	标本数	病毒阳性数	EV71	COXA16	COXA6	COXA10	其他EV
0~	92	37(40.22)	15(40.54)	9(24.32)	8(21.62)	1(2.70)	4(10.81)
1~	457	214(46.83)	65(30.37)	39(18.22)	69(32.24)	6(2.80)	35(16.36)
2~	611	277(45.34)	94(33.94)	66(23.83)	51(18.41)	3(1.08)	63(22.74)
3~	516	248(48.06)	92(37.10)	96(38.71)	21(8.47)	2(0.81)	37(14.92)
4~	321	150(46.73)	61(40.67)	57(38.00)	11(7.33)	2(1.33)	19(12.67)
5~	173	79(45.66)	30(37.97)	30(37.97)	5(6.33)	0(0.00)	14(17.72)
6~	93	39(41.94)	14(35.90)	17(43.59)	2(5.13)	1(2.56)	5(12.82)
7~	93	40(43.01)	11(27.50)	20(50.00)	2(5.00)	0(0.00)	7(17.50)
>18	4	1(25.00)	0(0.00)	0(0.00)	0(0.00)	0(0.00)	1(100.00)
合计	2 360	1 085(45.97)	382(35.21)	334(30.78)	169(15.58)	15(1.38)	185(17.05)
χ²值		4.096	7.056	46.133	77.169	8.406	15.663
P值		0.848	0.531	< 0.001	< 0.001	0.433^a	0.047
注：^a表示采用Fisher确切概率法。

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