摘要目的 探索手足口病患者愈后粪便标本中肠道病毒(EV)核酸阳性率的持续时间.方法 对49例手足口病实验室确诊病例进行连续6周的随访,每周采集1次患者的粪便标本5～8 g,用RT-PCR法检测手足口病常见病毒的核酸,用Kaplan-Meier生存分析法分析随访期内EV核酸检出情况.结果 49例患者中包括16例肠道病毒71( EV71)型、15例柯萨奇病毒A16(CoxA16)型和18例EV型.对患者进行病后6周的随访.EV71型患者在第1周和第5周各有1例失访,CoxA16型患者在第4周有1例失访,EV型患者在第1周有2例失访.在随访的第1～6周,EV71型患者病毒核酸阳性率分别为81.3％、60.9％、47.4％、33.9％、27.1％、18.1％,CoxA16型患者分别为93.3％、73.3％、53.3％、33.3％、16.7％、8.3％；随访的第1～2周,EV型患者病毒核酸阳性率分别为44.4％和7.4％,第3～6周均为0.3组患者在随访期内病毒核酸阳性率分布差异有统计学意义(x2=11.78,P=O.001).随时间的延长,各组患者病毒核酸阳性率均呈下降趋势.结论 手足口病患者愈后粪便中病毒核酸阳性率持续较长的时间,EV71型和CoxA16型患者可长达6周.

abstractsObjective To explore the duration of enterovirus (EV) nucleotides positive in feces samples of hand-foot-mouth disease ( HFMD ) patients after recovery.Methods A consecutive 6-week follow up were carried out towards 49 cases of laboratory-diagnosed HFMD patients.A total of 5 - 8 g feces sample was collected from each patient once a week.The common EV nucleotides of HFMD were detected by RT-PCR method and analyzed by Kaplan-Meier Survival Analysis Method.Results The subtypes of the 49 HFMD patients included 16 enterovirus 71 ( EV71 ),15 coxasckievirus A16 (CoxA16) and 18 EV; a sixweek follow up was carried out among all of them.In the first week,one EV71 patient and two EV patients were lost; in the fourth week,one CoxA 16 were lost; and in the fifth week,one EV71 patient was lost.During the consecutive 6-week follow-up,the positive rates of EV nucleotides among EV71 patients were 81.3％,60.9％,47.4％,33.9％,27.1％ and 18.1％ separately; and the positive rates in CoxA16 group were 93.3％,73.3％,53.3％,33.3％,16.7％ and 8.3％ respectively.In EV group,the positive rates of EV nucleotides were 44.4％ and 7.4％ in the first two weeks and then turned to negative in the next 4 weeks.There was significant statistical difference in positive rates of EV nucleotides among different patients ( x2 =11.78,P =0.001 ); however,each group of HFMD patients showed a declined trend with the extension of time.Conclusion The duration of EV nucleotides positive in feces samples of HFMD patients lasted for a long period since their recovery; and the positive results in EV71 and CoxA16 patients might last for 6 weeks.