摘要
目的 分析肠道病毒71型（EV71）感染手足口病重症患儿的脑脊液特点和临床特征.方法 对杭州市儿童医院2013年5至8月收治的经反转录聚合酶链反应（RT-PCR）检测EV71阳性的重症手足口病患儿（EV71感染组）114例进行脑脊液常规和生化检查,并与同期入院的其他肠道病毒感染的78例重症手足口病患儿（对照组）脑脊液检测结果作比较,结合临床表现进行分析.计数资料的比较采用x2检验,计量资料的比较采用Mann-Whitney U检验.结果 EV71感染组呕吐（35.1％）和肢体抖动（50.9％）的发生率高于其他肠道病毒组,差异均有统计学意义（x2=7.864和19.682,P＜0.05）;EV71感染组中脑脊液有核细胞计数≥100×106/L的患儿肢体抖动的发生率高于脑脊液有核细胞计数＜ 100×106/L的患儿（72.3％比35.8％,x2=14.740,P=0.000）;EV71感染组脑脊液有核细胞计数和蛋白质定量及阳性率明显高于其他肠道病毒感染组（Z=-9.458和-6.591,P=0.000;x2=105.421和10.932,P=0.000和0.001）.结论 EV71感染重症手足口病患儿神经系统损伤的临床症状及脑脊液检测的异常值较其他肠道病毒感染的重症患儿严重,且EV71感染组脑脊液有核细胞计数越高,肢体抖动越明显.
Objective To investigate cerebrospinal fluid characteristics and clinical features in children with severe hand,foot and mouth disease （HFMD） induced by enterovirus 71 （EV71） infection.Methods A total of 114 children with severe HFMD,in whom EV71 was detected by reverse transcription polymerase chain reaction （RT-PCR）,were admitted in Hangzhou Children＇s Hospital during May and August 2013.Seventy-eight children with severe HFMD induced by other enteroviruses admitted at the same period served as controls.The results of cerebrospinal fluids （CSF） routine examination and biochemical tests,and the clinical symptoms were compared between two groups.Differences in enumeration data were compared with x2 test,and measurement data were compared with Mann-Whitney U test.Results The incidences of vomiting and limb shaking in EV71 infection group were 35.1％ and 50.9％,which were higher than those in control group （x2 =7.864 and 19.682,P ＜ 0.05）.The incidence of limb shaking in children with nucleated cells count ≥ 100 × 106/L in EV71 group was higher than that with nucleated cells count ＜ 100 × 106/L （72.3％ vs.35.8％,x2 =14.740,P =0.000）.The nucleated cells count,protein quantity and their positive rates in EVT1 infected group were higher than those in control group （Z =-9.458 and-6.591,P=0.000; x2=105.421 and 10.932,P =0.000 and 0.001）.Conclusion The symptoms of nervous system damage and abnormal CSF examination were more serious in HFMD induced by EV71 infection,and in EV71 infected patients the incidence of limb shaking is correlated with nucleated cell count in CSF.
出处
《中华临床感染病杂志》
CAS
2014年第1期60-63,共4页
Chinese Journal of Clinical Infectious Diseases
基金
浙江省自然科学基金（LY13H040007）
浙江省医药卫生科技计划（2012KYB159）
关键词
手足口病
肠道病毒71型
柯萨奇病毒感染
脑脊髓液
Hand, foot and mouth disease
Enterovirus 71
Coxsackievirus infections
Cerebrospinal fluid
