北京市手足口病重症病例影响因素研究  

Study on the influential factors in severe cases of hand-foot-mouth disease in Beijing

作　　者：李锡太[1] 李婧楠[2] 贾蕾[1] 钱海坤[1] 孙瑛[1] 李洁[1] 高志勇[1] 王全意[1] 

机构地区：[1]北京市疾病预防控制中心传染病地方病控制所,北京100013 [2]北京大学第三医院,北京100013

出　　处：《国际病毒学杂志》2014年第5期198-202,共5页International Journal of Virology

基　　金：2010年北京市卫生局青年科研资助项目

摘　　要：目的了解北京市手足口病（hand-foot-mouthdisease，HFMD）重症病例的流行特征，探讨手足口病重症病例发病的影响因素，为早期发现手足口病重症病例、降低死亡病例发生风险提供依据。方法以北京市2012年报告的手足口病重症病例作为病例组，手足口病普通病例作为对照组，使用Logistic回归分析对手足口病重症病例发病危险因素进行分析。结果单因素Logistic回归分析结果显示年龄、职业、初诊医院类型、初诊是否正确诊断为手足口病、发病前一个月是否接种疫苗、发病前是否接触患病儿童、病原学类型这7个因素有统计学意义；多因素Logistic回归分析结果显示：散居儿童、初诊未正确诊断为手足口病、发病前接触过患病儿童和感染EV71病毒是手足口病重症病例的影响因素，OR值（95％cU分别为1．52（1．02-2．45）、11．49（5．05-26．32）、1．75（1．07～2．84）和2．87（1．42-5．85）。结论加强对散居儿童疾病监测，对发病儿童及时进行隔离，对儿童家长进行健康宣教，通过培训等途径提高医师的诊治水平，提高病原学检测、监测水平是防制手足口病重症病例的有效措施。Objective To investigate the epidemiological characteristics and the risk factors of se- vere hand-foot-mouth disease （HFMD） in Beijing, so as to provide basis for early diagnosis and to reduce se- vere or death cases of HFMD in Beijing. Methods All 352 severe cases of HFMD in 2012 reported by the China disease surveillance network reporting system were included in this study. 304 clinically diagnostic mild HFMD cases were selected as control group. Univariate and multivariate logistic regression analysis were used to evaluate the risk factors. Results Univariate analysis indicated that 7 factors had statistical significance, including age, occupation, hospital type at the initial visit, diagnosis of HFMD at the first visit and the etiology （ P 〈 0.05）. Multivariate analysis showed that the scattered children, not diagnosed as HFMD at the first visit, contacting with sick children before disease onset and enterovirus type were the risk factors, the odds ratios （95% CI） were 1.52 （1.02 -2. 45） ,11.49 （5.05 -26. 32）, 1.75 （ 1.07 -2. 84）, 2. 87 （ 1.42 - 5.85）, respectively. Conclusions Focused surveillance for the scattered children, health education for the parents, timely quarantine of HFMD patients, diagnosis and treatment training in the health service institutions as well as strengthening pathogen detection and monitoring capability are all effective measures for early detection, diagnosis and treatment of severe hand-foot-mouth disease.

关 键 词：手足口病 重症病例 危险因素 LOGISTIC回归分析 

分 类 号：R725.1[医药卫生—儿科]