云南省手足口病重症病例危险因素分析  

Analysis of the risk factors for severe hand-foot-and-mouth disease(HFMD) in Yunnan Province

作　　者：黄甜[1] 李琼芬[1] 沈秀莲[1] 伏晓庆[1] 寸建萍[1] 

机构地区：[1]云南省疾病预防控制中心,云南昆明650022

出　　处：《现代预防医学》2017年第6期1115-1119,共5页Modern Preventive Medicine

基　　金：国家科技重大专项传染病监测技术平台项目(项目编号:2016ZX10004212)

摘　　要：目的探讨云南省重症手足口病病例的危险因素。方法收集2009-2015年云南省手足口病高发的4个州(市)344例重症手足口病和440例普通手足口病诊断病例,分析手足口病重症的危险因素。结果多因素分析显示;自然分娩、半岁前全母乳喂养、主要看护人的文化程度高,初诊诊断为手足口病是重症手足口病的保护因素;明确传染源接触史、发病到就诊的时间长、发病到确诊的时间短、确诊手足口病的医院级别高、离家最近的医疗机构级别高、发热、EV71感染、流动人口、家庭年平均收入高、家庭人均居住面积小为重症手足口病的危险因素。结论流动人口、有明确手足口病传染源接触史、出现发热症状、且EV71病毒检测阳性的患儿是云南省重症手足口病的防控重点人群。提高医疗机构对手足口病的早期诊断能力,鼓励倡导自然分娩和半岁之前的全母乳喂养,均可预防手足口病重症的发生。Objective The study aimed to explore the risk factors for severe hand-foot-and-mouth disease （HFMD） in Yunnan Province. Methods A total of 344 severe cases and 440 average cases of HFMD were collected from four prefectures （cities） of Yunnan with high incidence of HFMD. The risk factors for severe HFMD were analyzed. Results Multiple-factor analysis showed that natural childbirth, complete breast feeding before 6 months old, and high educational background of major care taker, and correct initial diagnosis were the protective factors against severe HFMD. Clear history of contacting an infection source, long duration from onset to clinical visit, short duration from onset to diagnosis, high administrative levelof hospital for diagnosis, high administrative level of medical institution closest to patient＇s home, fever, EV71 infection, migrant population, high average yearly family income, and small familyliving space per capita were the risk factors for severe HFMD. Conclusion Young patients being of the migrant population, having clear history of contacting an infection source of HFMD, having fever, and having tested positive EV71 of viral detection are the key population for prevention and control of HFMD in Yunnan Province. Improving early diagnosis capability for HFMD in medical institutions and encouraging natural childbirth and complete breast feeding before 6 months of age is expected to prevent the occurrence of severe HFMD.

关 键 词：手足口病 重症病例 危险因素 

分 类 号：R181.2[医药卫生—流行病学]