【摘要】：腸道病毒71型（Enterovirus71，EV71）是手足口病（hand,foot and mouthdisease,HFMD）的主要病原體之一。近期，在亞洲兒童中，EV71已經(jīng)引起了危及生命的大爆發(fā)流行，主要累及神經(jīng)和心肺系統(tǒng)，但具體機(jī)制至今仍不明確。EV7l感染可導(dǎo)致全球性流行，四季均可致病，以夏秋季為發(fā)病高峰，潛伏期2～10天，平均3～5天。傳染源包括患者、隱性感染者及健康帶毒者。EV71主要通過(guò)消化道、呼吸道及直接接觸患者鼻喉分泌液、唾液、水皰液、糞便等途徑傳播。此病多發(fā)生于5歲以內(nèi)兒童，尤其是3歲以內(nèi)嬰幼兒，以手、足、臀部位皮膚及口腔粘膜的皰疹為典型表現(xiàn)，起病時(shí)多有發(fā)熱，伴有咽部疼痛，大多數(shù)預(yù)后良好，少數(shù)病例可出現(xiàn)致命的神經(jīng)系統(tǒng)、呼吸系統(tǒng)及循環(huán)系統(tǒng)并發(fā)癥，如無(wú)菌性腦膜炎、脊髓灰質(zhì)炎樣麻痹、病毒性腦炎、神經(jīng)源性肺水腫（neurogenic pulmonaryedema,NPE）及心肌炎。 EV71是目前最具有嗜神經(jīng)性的腸道病毒（Enterovirus，EV），EV71感染最嚴(yán)重的并發(fā)癥是NPE，NPE病程進(jìn)展迅速、治療困難、病死率高，對(duì)我國(guó)兒童健康造成了嚴(yán)重危害，由EV71感染所導(dǎo)致的NPE近年來(lái)受到人們的廣泛關(guān)注，雖然臨床報(bào)道很多，但其發(fā)病機(jī)制目前尚不十分清楚，另外，目前還沒(méi)研制出相應(yīng)的疫苗或抗病毒藥物用于EV71引起的疾病的預(yù)防和治療，因此，，針對(duì)EV71的基礎(chǔ)研究對(duì)目前HFMD高發(fā)態(tài)勢(shì)下的公共衛(wèi)生形勢(shì)來(lái)說(shuō)顯得十分迫切和意義重大。故本文通過(guò)對(duì)EV71的流行病學(xué)、病原學(xué)，EV71致NPE的發(fā)病機(jī)制、診斷、鑒別診斷及治療作一系統(tǒng)論述，為EV71致NPE的研究提供參考。
[Abstract]:Enterovirus 71 (Enterovirus71,EV71) is one of the main pathogens of hand, foot and mouth disease (hand,foot and mouthdisease,HFMD). Recently, among Asian children, EV71 has caused a life-threatening outbreak, mainly involving the nervous and cardio-pulmonary system, but the specific mechanism is still unclear. EV 7l infection can lead to a global epidemic, and can cause disease throughout the four seasons. The peak of onset was summer and autumn, and the incubation period was 2-10 days (average 3-5 days). EV71 is mainly transmitted through digestive tract, respiratory tract and direct contact with nasal and laryngeal secretions, saliva, vesicular fluid, feces and so on. The disease usually occurs in children under 5 years of age, especially infants under 3 years of age. The typical manifestation of this disease is herpes in the skin and oral mucosa of the hands, feet, buttocks, and oral mucosa. Most of them have fever and sore pharynx when they start the disease, and most of them have a good prognosis. Fatal neurological, respiratory and circulatory complications such as aseptic meningitis, poliomyelitis, viral encephalitis, neurogenic pulmonary edema (neurogenic pulmonaryedema,NPE) and myocarditis can occur in a few cases. EV71 is the most neurotropic enterovirus (Enterovirus,EV) at present. The most serious complication of EV71 infection is the rapid progress of the course of disease, the difficulty of treatment and the high mortality of NPE,NPE, which has caused serious harm to the health of children in China. NPE, caused by EV71 infection, has received extensive attention in recent years. Although many clinical reports have been reported, the pathogenesis of NPE is still unclear. In addition, At present, the corresponding vaccines or antiviral drugs have not been developed for the prevention and treatment of EV71-induced diseases. Therefore, the basic research on EV71 is very urgent and significant to the public health situation under the situation of high incidence of HFMD. In this paper, the epidemiology, etiology, pathogenesis, diagnosis, differential diagnosis and treatment of EV71-induced NPE were systematically discussed in order to provide a reference for the study of EV71-induced NPE.
【學(xué)位授予單位】：蚌埠醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R725.1

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