小儿重症手足口病临床特征及危险因素分析  

Clinical features and risk factors of severe cases of HFMD

作　　者：林海波[1] 刘晓娟[2] 钟文明[3] 

机构地区：[1]广东省深圳市宝安区妇幼保健院儿科,518133 [2]广东省深圳市宝安区妇幼保健院中医科,518133 [3]广东省深圳市宝安区妇幼保健院信息科,518133

出　　处：《职业与健康》2013年第16期2056-2058,共3页Occupation and Health

摘　　要：目的探讨重症手足口病(HFMD)患儿的临床特征及其危险因素,为防治HFMD提供依据。方法回顾性收集56例重症HFMD病例、56例普通HFMD病例、60例非HFMD儿科病例,比较分析重症组和普通组的临床特征,了解影响重症HFMD发病的危险因素。结果重症HFMD病例组与普通病例组相比,具有发热持续时间长(2.58 d)、热峰高(39.35℃)、外周血WBC计数高(12.49×109/L)、外周血中性粒细胞比例高(57.6%)、血糖浓度高(6.88 mmol/L),ECG(窦速,78.6%)、神经系统(89.3%)、呼吸系统(21.4%)、循环系统(53.6%)、X线异常比例(58.6%)高等特点(P<0.05);影响重症HFMD发病的危险因素包括儿童卫生习惯不良(OR=1.602)、家庭人口密集(OR=2.872)、病例接触史(OR=2.303)、发热持续时间(OR=1.629)、神经系统症状(OR=3.869)、EV71阳性(OR=6.085)、血糖(OR=1.536)。结论了解重症HFMD的临床特征和危险因素,可为早发现、早诊断、早治疗重症HFMD提供临床依据。[ Objective ] To explore clinical features and risk factors of severe hand foot mouth { HFMD} cases, and provide basis for preventing and treating HFMD. [ Methods] Fifty-six cases of severe HFMD, 56 cases of common HFMD and 60 pediatrics cases of non-HFMD were retrospectively collected to compare clinical features between the common group and the severe group, and to un- derstand the risk factors influencing the incidence of severe HFMD. [ Results ] In contrast with the common group, tThe severe HFMD group had longer fever lasting time（2.58 d）, higher fever peak{ 39.35 ℃, more WBC{ 12.49 ×10^9/L}, higher peripher- al blood neutrophil ratio {57.6% }, higher blood glucose concentration 16.88 retool/L}, much higher abnormality ratios on ECG { sinus tachycardia, 78.6 % }, nervous system{ 89.3% }, respiratory apparatus {21.4% }, circulation system {53.6% } and X ray abnormality symptoms { 58.6% } （ P 〈 O. 05 } . The risk factors of severe HFMD included bad health habit of child { OR = 1. 602 }, dense population of family （ OR = 2. 872 }, history of case exposure { OR = 2 . 303 }, fever lasting time { OR = 1. 629 }, nervous system symptom （ OR = 3. 869 }, positive EV71 （ OR = 6. 085 } and blood glucose { OR = 1. 536 } . [ Conclusion] The understanding of clinical features and risk factors of severe cases of HFMD can provide clinical basis for early detection, early diagnosis and early treatment of severe HFMD .

关 键 词：手足口病(HFMD) 重症 肠道病毒 临床特征 危险因素 

分 类 号：R181.8[医药卫生—流行病学]