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目的了解郴州市HFMD病原谱变迁规律,为HFMD的防治提供依据。方法采集HFMD临床诊断标本,应用荧光PCR方法检测人肠道病毒通用型、HEV71、CVA16、CVA6和CVA10。结果郴州市2010年-2014年共检测HFMD标本3 997份,人肠道病毒阳性2 756份,检出阳性率为68.95%,每年的优势毒株依次为HEV71(55.17%)、CVA16(32.54%)和HEV71(30.15%)、HEV71(61.71%)、CVA6(41.55%)、CVA16(27.91%)和HEV71(23.74%)。郴州地区及同一地理类型地区不同年度的病原体型别构成比差异有统计学意义(P<0.05);各年度不同流行阶段、年龄阶段和病原体型别构成比差异均有统计学意义(P<0.05)。结论郴州市2010年-2014年HFMD流行的主要病原体,以HEV71、CVA16、CVA6交替流行为主,或同时流行;新的主要病原体CVA6流行强度不亚于HEV71;多种优势型别毒株的快速交替流行,是郴州地区近5年HFMD疫情的持续高发的主要原因;重症及死亡病例以HEV71感染为主,但非HEV71和CVA16感染有逐年增多趋势。
Objective To understand the pathological changes of HFMD in Chenzhou and provide the basis for the prevention and treatment of HFMD. Methods Clinical samples of HFMD were collected, and the common type of human enterovirus, HEV71, CVA16, CVA6 and CVA10 were detected by fluorescence PCR. Results A total of 3 997 samples of HFMD and 2 756 human enteroviruses were detected in Chenzhou from 2010 to 2014. The positive rate was 68.95%. The dominant strains were HEV71 (55.17%), CVA16 (32.54% ) And HEV71 (30.15%), HEV71 (61.71%), CVA6 (41.55%), CVA16 (27.91%) and HEV71 (23.74%). There were significant differences in the constitutional types of pathogens between Chenzhou area and the same geographic area in different years (P <0.05). There were significant differences in the constitutional ratios of pathogens at different epidemic stages in each year (P <0.05) ). Conclusions The major pathogens of HFMD epidemic in Chenzhou from 2010 to 2014 are predominant or concurrent with HEV71, CVA16 and CVA6. The prevalence of CVA6, a new major pathogen, is as high as that of HEV71. The rapidity of rapid growth of many dominant strains The prevalence of HFMD epidemic in Chenzhou was the main cause of the continuous high incidence of HFMD in Chenzhou in recent 5 years. The severe and fatal cases were mainly infected with HEV71, but the non-HEV71 and CVA16 infections were increasing year by year.