摘要目的 了解粤东地区2010年手足口病患儿的病原学特点并探讨实时RT-PCR法检测手足口病患儿咽拭子和疱疹液样本病原体的敏感性.方法 收集94例手足口病(重症35例,轻症59例)患儿的咽拭子和疱疹液样本,以肠道病毒(EV)通用型、柯萨奇病毒A16(CA16)型、肠道病毒71(EV71)型核酸检测试剂盒,应用实时RT-PCR法检测样本中的EV,并结合临床资料对样本阳性率的样本进行比较.结果 94份咽拭子样本中,EV通用型阳性59例(62.77％),EV71阳性49例(52.13％),CA16阳性18例(19.15％),其中35份重症患儿咽拭子样本中EV通用型阳性31例(88.57％),EV71阳性23例(65.71％),CA16阳性7例(20.00％)；94份疱疹液样本中EV通用型阳性44例(46.81％),EV71阳性33例(35.11％),CA16阳性15例(15.96％),其中35份重症患儿疱疹液样本中EV通用型阳性22例(62.86％),EV71阳性15例(42.86％),CA16阳性6例(17.14％).统计资料显示,咽拭子的阳性率高于疱疹液,EV71的检出率差异有统计学意义(x2=5.537,P＜0.05),重症患儿EV71阳性率高于轻症患儿,两组患儿的EV通用型及EV71检出差异有统计学意义(x2=15.889、4.125,P＜0.05).结论 2010年我院手足口病住院患儿的病原体主要为EV71和CA16,并且以EV71为主.应用实时RT-PCR法检测手足口病病原体,咽拭子的病毒检出率较疱疹液高,重症患儿的病毒检出率明显高于轻症患儿.

abstractsObjective To investigate the etiologic characteristics of hand,foot and mouth disease(HFMD)in eastern Guangdong and to compare the sensibility of RT-PCR testing pathogen in throat swabs and vesicle fluid.Methods Throat swabs and vesicle fluid were collected from 94 children with HFMD(including 35 severe cases and 59 mild cases).Nucleic acids of three type of viruses of enterovirus coxsackievirus A16(CA16),enterovirus 71(EV 71 )and EV were detected by RT-PCR.Results In all the 94 cases,the EV,EV71 and CA16 positive rate in throat swabs samples were 62.77％ (59 cases),52.13％ (49 cases) and 19.15％ (18 cases) respectively,including 88.57％ (31 cases),65.71％(23 cases) and 20.00％(7 cases) positive rates in 35 severe cases.However,EV,EV71 and CA16 positive rate in 94 vesicle fluid were 46.81％ (44 cases),35.11％ ( 33 cases),15.96％ ( 15 cases),including 62.86％ (22cases),42.86％(15 cases) and 17.14％(6 cases) in 35 severe cases.The positive rate of EV71 by RT-PCR in throat swabs was higher than in vesicle fluid ( x2 =5.537,P ＜ 0.05),and the positive rates of EV and EV71 in severe cases were also much higher (x2 =15.889,4.125,P ＜ 0.05).Conclusions EV71 and CA16 are common in children in our hospital,and most patients are infected with EV71.RT-PCR is hypersensitive for testing HFMD pathogens in throat swabs.The positive rate of HFMD in severe case is much higher than mild cases.