云南省手足口病高发病地区重症病例影响因素分析及预测模型建立  

Analysis of influencing factors for severe cases in children with hand, foot and mouth disease and establishment of probability model in epidemic areas in Yunnan province

作　　者：沈秀莲[1] 王俊瑛[2] 李琼芬[1] 林燕[1] 黄甜[1] 

机构地区：[1]云南省疾病预防控制中心,云南昆明650022 [2]昆明医科大学,云南昆明650500

出　　处：《现代预防医学》2016年第14期2502-2506,共5页Modern Preventive Medicine

摘　　要：目的探讨云南省手足口病高发病地区重症病例发生的影响因素,建立预测模型,为制定防控措施提供科学依据。方法采用自行设计的调查表开展调查,收集云南省手足口病发病数前四的州(市)(昆明市、红河州、玉溪市、曲靖市)2009-2013年的病例资料共788例,其中重症病例346例(43.90%),轻症病例442例(56.09%),运用非条件Logistic回归分析方法研究手足口病重症病例的影响因素,并建立回归模型。结果多因素非条件Logistic回归结果显示,发病前与其玩耍的孩子发病(OR=4.705)、初诊在村(个体)诊所(OR=1.753)、发热持续3 d以上(OR=1.155)、住院治疗(OR=4.100)、发高热(OR=2.980)为重症手足口病发生的危险因素;CoxA16阳性(OR=0.503)、自然分娩(OR=0.471)、看护人文化程度为高中以上(OR=0.382)是重症手足口病发生的保护因素。根据结果建立预测模型,模型的灵敏度为91.04%,特异度为85.97%,准确率为64.09%。结论重症手足口病的模型可定量评估重症手足口病发生的概率。Objective This work was to explore the influencing factors of severe cases of hand, foot and mouth disease （HFMD） in epidemic areas in Yunnan province, and to establish a risk model for the early diagnosis of the severe patients, and to provide scientific evidence for its prevention and control. Methods Descriptive epidemiological analysis was conducted by uniform questionnaire on the incidence data of severe cases of HFMD in Yunnan Province （Kunming, Honghe, Yuxi, Qujing） from 2009 to 2013. A total of 788 cases were surveyed,including 346 severe eases and 442 mild cases. Logistic regression analysis was conducted to identify the related influencing factors and establish a risk model. Results The results of multivariate logistic regression analysis showed that contact history （OR = 4.705）, first-diagnosis in a country level clinic （OR = 1.753）, fever over 3days （OR = 1.155）, hospitalization （OR = 4.100） and high fever （OR = 2.980） were risk factors. CoxA16 positive （OR = 0.503）, natural childbirth （OR = 0.471）, if the education level of the care-provider of HFMD patient was high school education or above （OR = 0.382） were protective factors. The risk model predicted severe cases well, with sensitivity, specificity and consistency to be 91.04%, 85.97% and 64.09%, respectively. Conclusion The risk model could quantitatively predict sever cases with HFMD.

关 键 词：手足口病 重症 影响因素 模型 

分 类 号：R181.13[医药卫生—流行病学]