儿童手足口病1570例危险因素的病例对照研究  

Caselcontrol study on risk factors of hand-foot-mouth disease in 1 570 children

作　　者：杨朝晖[1] 秦承志[1] 季金萍[2] 王成宝[1] 

机构地区：[1]山东省临沂市人民医院感染科,276000 [2]山东省临沂市人民医院儿科,276000

出　　处：《中华传染病杂志》2014年第3期154-157,共4页Chinese Journal of Infectious Diseases

摘　　要：目的研究儿童手足口病发生重症的危险因素。方法采用回顾性研究方法，调查2011年山东省临沂市人民医院感染科1570例住院患儿临床资料，数据分析采用单因素、多因素Logistic回归分析。结果重症组（包括重症和危重症）患儿年龄为（25．0±14．0）个月，以1-5岁居多；轻症组为（27．1±15．8）个月（t’=-2．717，P=0．007）。两组男童分别占61．0％和65．9％（y2=3．894，P=0．048）。重症组伴有发热、惊厥、肢体抖动、呕吐等表现者多于轻症组，中性粒细胞、CK明显高于轻症组。单因素Logistic回归分析显示，年龄（OR=1．799，95％CI：0．984-1．997）、女童（OR=1．234，95％CI：1．001-1．522）、高热（OR=2．110，95％CI：1．816-2．452）、惊厥（OR=1．878，95％CI：1．578-2．236）、恶心呕吐（OR=1．760，95％CI：1．456-2．128）、中性粒细胞增高（OR=1．031，95％CI：1．025-1．037）、CK增高（OR=1．002，95％CI：1．001-1．003）是儿童重症手足口病发生的危险因素。多因素Logistic回归分析显示，高热（OR=1．751，95％Cr：1．487-2．062）、惊厥（OR=1．451，95％cI：1．204-1．749）、恶心呕吐（OR=1．269，95％C1：1．027-1．568）、中性粒细胞增高（OR=1．028，95％CI：1．021-l.035）是重症手足口病的危险因素。结论密切关注手足口病患儿的体温、神经系统表现和中性粒细胞改变，可有效降低其发展为重症的可能性。Objective To study the risk factors of severe hand-{oot-mouth disease （HFMD） among children. Methods The clinical data of 1 570 children with HFMD at Linyi People＇s Hospital in Shandong Province in 2011 were collected, retrospectively. The data were analyzed using univariate and multivariate Logistic regression. Results The mean age of severe HFMD （including severe and critical HFMD） was （25. 0±14. 0） months old, predominantely aged between 1 and 5 years old, while mild HFMD was （27.1±15.8） months （t＇=-2.717, P=0.007）. There were 61.0% and 65.9% boys in two groups, respectively （X2= 3. 894, P=0. 048）. Fever, convulsion, tremor, nausea and vomiting were more frequently seen in severe HFMD. The neutrophil count and the level of creatine kinase in severe HFMD were both significantly higher than that in mild HFMD. Univariate analysis revealed that age （odds ratio [OR]=l. 799, 95%CI： O. 984--1. 997）, girl sex （OR= 1. 234, 95%CI： 1.001--1.522）, high fever （OR=2. 110,95%CI： 1. 816--2. 452）, convulsion （OR= 1. 878, 95%CI： 1. 578--2. 236）, nausea and vomiting （OR=I. 760, 95%CI： 1. 456--2. 128）, neutrophil count （OR= 1. 031, 95%CI： 1. 025-- 1. 037） and creatine kinase （OR=I. 002, 95%CI： 1. 001--1. 003） were risk factors for severe HFMD. Multivariate Logistic regression showed that high fever （OR = 1. 751, 95% CI： 1. 487- 2. 062）, convulsion （ORal. 451, 95%CI： 1. 204--1. 749）, nausea and vomiting （OR=I. 269, 95%CI： 1. 027-- 1. 568）, neutrophil count （OR= 1. 028, 95%CI： 1. 021-- 1. 035） were independent risk factors. Conclusions Body temperature, neurological manifestations and trend of neutrophil counts should be carefully monitored in children with HFMD. Prevention of the development of severe HFMD mainly relieson the identification of risk factors and adoption of precautions in time.

关 键 词：手足口病 发热 神经病学表现 白细胞增多 中性白细胞 病例对照研究 

分 类 号：R725.1[医药卫生—儿科]