重庆市手足口病重症病例危险因素研究  

A Case-control Study on the Risk Factors of Severe Hand-foot-mouth Disease in Chongqing City

作　　者：张科[1,2] 贺加[1] 周小兰[3] 陈先刚[2] 杨慧[2] 管龙志[4] 

机构地区：[1]第三军医大学军事预防医学院社会医学与卫生事业管理教研室,重庆400038 [2]重庆市渝中区疾病预防控制中心 [3]重庆医科大学附属第二医院病案统计科 [4]重庆医科大学附属儿童医院卫生保健科

出　　处：《华西医学》2016年第5期875-879,共5页West China Medical Journal

基　　金：国家科技重大专项(2012ZX10004212-004)~~

摘　　要：目的探讨重庆市儿童重症手足口病病例的影响因素,为今后征对性开展干预工作,降低手足口病重症病例的发病率和病死率提供参考。方法收集2011年-2014年重庆市90例重症手足口病和90例轻症手足口病病例,以轻症病例为对照组,重症病例为病例组,进行重症病例的危险因素研究分析。采用统一调查表进行调查,资料应用Epi Data 3.1软件建立数据库,使用SPSS 13.0软件进行单因素和多因素非条件logistic回归分析。结果单因素分析发现病毒类型、户口类型、现住址类型、照看人文化程度、发病季节、是否发热、是否出疹、初次就诊医院类型、初诊是否确诊手足口病等14个因素为重症手足口病的影响因素(P<0.05)。多因素分析结果显示,现住地类型为农村[OR=27.29,95%CI(3.71,200.72)]、首次就诊未确诊手足口病[OR=141.03,95%CI(12.43,1 599.70)]、感染病毒类型为肠道病毒71型[OR=244.32,95%CI(18.99,3 143.74)]为重症病例的危险因素。结论应针对重症手足口病的危险因素开展主动监测,同时积极采取有效的预防措施,及时对重症患儿进行对症治疗,有助于降低重症手足口病病例的发病率和病死率。Objective To explore the risk factors associated with severe hand-food-mouth disease（HFMD） in Chongqing,in order to carry out intervention work in the future,provide reference for reducing the incidence and fatality rate of severe HFMD cases.Methods Ninety severe HFMD cases treated between 2011 and 2014 in Chongqing were enrolled as case group while another 90 mild HFMD cases were randomly selected as control group in the same period.All subjects＇ parents or babysitters were asked to fill in a questionnaire which included demography,ways of babysitting,behavior and the like.All HFMD cases were diagnosed by both clinical symptoms and nuclear acid testing.Data were processed by EpiData 3.1 and analyzed by SPSS 13.0.Results Single-factor analysis showed that there were 14 risk factors of severe HFMD including virus type,registered residence type,current address type,cultural degree of their caregivers,season of the onset,existence of fever and rash,first hospital diagnosis type,and whether the first diagnosis was HFMD（P〈0.05）.Multifactor analysis showed the risk factors included the current rural residence type[OR=27.29,95%CI（3.71,200.72）],misdiagnosis as disease other than HFMD in the first visit to the hospital[OR=141.03,95%CI（12.43,1 599.70）],and virus type of EV71[OR=244.32,95%CI（18.99,3 143.74）].Conclusions Active surveillance should be carried out on the risk factors of severe HFMD.At the same time,active and effective preventive measures,and timely treatment of patients with severe HFMD can help to reduce the incidence and case fatality rate.

关 键 词：手足口病 重症病例 危险因素 

分 类 号：R725.1[医药卫生—儿科]