手足口病重症病例临床特征的Fisher逐步判别分析  

Step Fisher discriminant analysis on severe clinical features of hand foot and mouth disease between enterovirus （EV） 71 and other

作　　者：阮峰[1] 谭爱军[1] 张雪宝[1] 陈雪琴[1] 萧松健 叶中文[1] 王松[1] 

机构地区：[1]广东省珠海市疾病预防控制中心,519002

出　　处：《中华流行病学杂志》2011年第7期716-719,共4页Chinese Journal of Epidemiology

摘　　要：目的比较肠道病毒（EV）71型（EV71）与其他EV感染手足口病重症病例的临床特征，寻找EV71手足口病重症病例的特异性诊断指标。方法病例定义采用卫生部“手足口病诊疗指南（2010年版）”，通过查阅病历及现场个案调查，获得定点收治医院手足口病重症病例的临床资料，PCR检测粪便标本中EV、Ev71及CoxA16等核酸。比较EV71与其他EV感染的手足口病重症病例临床特征，有统计学意义的指标进行Fisher逐步判别分析。结果EV71与其他Ev感染的手足口病重症病例比较，肢体抖动、易惊、精神差、抽搐等神经系统症状和体征以及脑脊液自细胞计数升高等指标的差异有统计学意义（P〈0．05），Fisher逐步判别分析发现肢体抖动、脑脊液白细胞计数升高有统计学意义。EV71和其他EV感染的判别方程分别为y=3．059X1＋3．83X5-2．742和y=1．634X1＋1．623X5-1．693，EV71判别正确性为91％，其他EV判别正确性为40％。结论肢体抖动和脑脊液白细胞计数升高可作为EV71重症病例的判别诊断指标。Objective To compare the clinical features of severe hand foot and mouth disease between enterovirus （EV） 71 and other EV to find specific diagnosis index of EV71 severe hand foot and mouth disease. Methods Case definition were adopted from national guideline of hand foot and mouth disease diagnose （Version 2010）. Clinical data of severe hand foot and mouth disease came from case history and contents of questionnaire would include the ones between the time of onset and diagnoses being made. EV and EV71, Cox A16 nucleic acid tested were by RT-PCR in stool samples. Clinical features of severe hand foot and mouth disease between EV71 and other EV were compare. Results There appeared statistical differences between neurologic symptoms such as tremor, myoclonie jerk, listlessness, convulsion and white blood cell counts in CSF （P〈0.05）. Results from the step Fisher discriminant analysis showed only tremor and white blood cell had an increase in CSF, with statistically significant differences. The discriminant equation of EV71 was Y=3.059X1＋3.83X5 -2.742 and the equation of other EV was Y= 1.634X1＋ 1.623X5-1.693. The specificity of EV71 was 91% and the specificity of other EV was 40%. Conclusion The increase of clinical features of tremor and white blood cell in CSF could be used as diagnosis index of severe EV71.

关 键 词：手足口病 重症病例 临床特征 判别分析 

分 类 号：R725.1[医药卫生—儿科]