468例手足口病临床特点及轻重型病例比较  

Clinical feature of 468 cases with hand-foot-and-mouth disease and comparison between mild and severe cases

作　　者：李梅[1] 党双锁[1] 高宁[1] 王文俊[1] 李亚萍[1] 贾晓黎[1] 翟嵩[1] 

机构地区：[1]西安交通大学医学院第二附属医院感染科,西安市710004

出　　处：《中华实验和临床感染病杂志（电子版）》2012年第1期34-38,共5页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

摘　　要：目的分析手足口病临床特点和重型病例的危险因素。方法收集2010年8月至11月西安交通大学第二附属医院和西安市儿童医院收治的468例手足口病患儿完整临床资料;将患儿年龄、性别、城乡分布、症状、体征和实验室检查等资料进行统计;随机抽取30例轻型病例与29例重型病例比较,应用单因素和多因素方法对资料进行分析。结果 468例手足口病患儿男女比例1.2∶1,其中385例(82.2%)为3岁以内婴幼儿,城乡分布为1.8∶1。临床表现为皮疹468例(100%),发热361例(77.1%),心率加快161例(34.4%)。轻重型组间比较结果显示,两组患者城乡分布、高热发生率和呕吐发生率差异均具有统计学意义。Logistic多因素回归分析结果显示血白细胞计数升高、高血糖、合并EB病毒感染为其相关危险因素。结论手足口病患儿以3岁以内婴幼儿为主,重型病例多发于农村。临床表现以皮疹、发热为主,出现高热、呕吐、心率加快者需警惕发展为重型病例的可能。血白细胞升高、高血糖以及合并EB病毒感染是重型病例的危险因素,尤其是高血糖,应引起高度重视。Objective To investigate the clinical feature of hand-foot-and-mouth disease （HFMD） and the risk factors of severe cases. Methods Clinical data of 468 patients with HFMD admitted to the Second Affiliated Hospital of Medical College, Xi＇ an Jiaotong University and Xi＇ an Children＇ s Hospital from August to November 2010 were collected. The data including the patients＇ age, gender, geographical distribution, clinical manifestation and laboratory examination were analyzed. Total of 30 mild cases were selected randomly and compared with 29 severe cases. Univariate and multivariate method for data analysis were carried out. Results Among of the 468 cases, male to female ratio was 1.2： 1, the proportion of urban and rural areas was 1.8： 1, and 385 （82.2%） cases were younger than 3 years old. Clinical manifestation showed that 468 （100%） cases had rash, 361 （77. 1%） cases got fever and 161 cases were found tachycardia. The rates of high fever, vomiting and tachycardia were significantly different between the two groups. Logistic muhiple regression analysis showed that leukocytosis, hyperglycemia and co-infection with EB virus were risk factors to severe cases. Conclusions Children younger than 3 years old are susceptible to HFMD and most severe cases happen in the countryside. The mainly clinical manifestations of HFMD are rash and fever, while high fever, vomiting, tachycardia may be used as warning indicators for early identification to severe cases. Leukocytosis, hyperglycemia and co-infection with EB are risk factors of severe cases, especially hyperglycemia, should be paid much attention to.

关 键 词：手足口病 疾病特征 危险因素 回归分析 

分 类 号：R725.1[医药卫生—儿科]