手足口病并发神经系统损害的临床特点及危险因素分析  

The clinical features of hand-foot-mouth disease complicated with nervous system damage and the analysis for its risk factors

作　　者：周大明[1] 沈雷[1] 宗文宏[1] 姜继军[1] 黄祖璇[1] 

机构地区：[1]南通大学医学院附属江苏省泰州市人民医院(南院)感染疾病科,南通225300

出　　处：《重庆医科大学学报》2010年第11期1724-1726,共3页Journal of Chongqing Medical University

摘　　要：目的:分析手足口病(Hand-foot-mouth disease,HFMD)并发神经系统损害的临床特点,探讨其危险因素。方法:回顾性分析我院926例HFMD资料,总结临床特点,并采用Logistic回归分析危险因素。结果:并发神经系统损害的HFMD患儿共52例(5.9%),男女性别比2.1∶1。平均年龄(2.5±2.1)岁,略低于普通的HFMD患儿(P<0.05)。高热发生率为51.9%,高于普通的HFMD患儿(P<0.05)。神经系统损害典型的症状依次是精神差、头痛、呕吐、易惊、嗜睡、颈抵抗、肢体抖动、肌阵挛、无力或瘫痪和共济失调等。52例患儿白细胞计数异常24例,血糖升高16例,均要高于普通的HFMD患儿(P<0.05)。EV71阳性率72.7%,也高于普通的HFMD患儿(P<0.05)。治疗痊愈49例,遗留左上肢无力1例,2例死于心跳停搏。死亡率也高于普通的HFMD患儿(P<0.05)。危险因素分析显示月龄越小、平时由爷爷奶奶或其他人照看、家庭月平均收入低,是HFMD并发神经系统损害的独立危险因素。结论:发神经系统损害的手足口病患儿有一定的临床特点,年龄较小的手足口病患儿,当出现高热、发呆、发抖时,要高度怀疑并发神经系统损害;而对于月龄越小、平时由爷爷奶奶或其他人照看、家庭月平均收入低这类患儿,更应该引起临床重视。Objective：To summarize the clinical features of hand-foot-mouth disease（HFMD） complicated with central nervous system damage,and analysis its risk factors.Methods：We summarized the clinical features by retrospective analysis of 926 cases of HFMD in our hospital,as well as risk factors analysis by Logistic regression.Results：A total of 52 children complicated with central nervous system damage in 874 HFMD patents（5.9%）.The sex ratio was 2.1：1.The average age was（2.5± 2.1） year,lower than normal HFMD patients（P0.05）.Heat rate was 51.9%,higher than normal HFMD patients（P0.05）.The typical symptoms of nervous system damage were headache,vomiting,easily frightened,lethargy,neck resistance,body shake,myoclonus,weakness or paralysis and ataxia and so on.24 children have abnormal white blood cell count,16 children have higher blood sugar,which were higher than normal HFMD children（P 0.05）.EV71-positive rate was 72.7%.49 cases were cured,1 cases left over the left upper limb weakness,2 patients died of cardiac arrest.Mortality is also higher than normal HFMD patients（P0.05）.Risk factor analysis showed that the smaller children,usually grandparents care,low average monthly household income,are the independent risk factor for central nervous system damage in HFMD.Conclusion：HFMD children with high fever,in a daze,shaking time are suspected to be a high degree of central nervous system damage;smaller age of months,cared by grandparents,low income families are the independent risk factor for central nervous system damage in HFMD,which should be paid more attention to.

关 键 词：手足口病 神经系统损害 并发症 临床特征 危险因素 

分 类 号：R512.5[医药卫生—内科学]