45793例儿童手足口病临床特点分析  

Analysis of clinical characteristics of 49 763 children with hand,foot and mouth disease

作　　者：李东明[1] 林明[2] 黄冠新[2] 

机构地区：[1]广西壮族自治区妇幼保健院检验科,南宁530003 [2]广西壮族自治区妇幼保健院医院管理感染科,南宁530003

出　　处：《中华妇幼临床医学杂志（电子版）》2017年第5期545-551,共7页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：广西壮族自治区自然科学基金项目(2013GXNSFAA019256)~~

摘　　要：目的探讨广西壮族自治区妇幼保健院收治手足口病(HFMD)患儿的临床特点。方法选择2013年1月1日至2016年12月31日,于广西壮族自治区妇幼保健院就诊的45 793例HFMD患儿为研究对象。在知情同意情况下,采集其中363例普通型HFMD患儿的咽拭子或(和)疱疹液,以及732例重症HFMD患儿的咽拭子标本,进行肠道病毒(EV)71、柯萨奇病毒(Cox)A16和其他EV检测。回顾性分析患儿病例资料,统计学分析本院2013—2016年HFMD如下特点。(1)每年HFMD重症率及病死率;(2)HFMD月份、年龄、性别、人群、地区分布特点,以及与这些因素相关的HFMD重症率情况;(3)HFMD病原学特点。本研究遵循的程序符合广西壮族自治区妇幼保健院伦理委员会制定的伦理学标准,得到该伦理委员会批准。结果(1)45 793例HFMD患儿中,普通型HFMD占98.40%(45 061/45 793),重症HFMD占1.60%(732/45 793),重症HFMD患儿的病死率为1.64%(12/732)。其中,2013年的HFMD重症率1.13%为最低,分别与2014年的1.85%、2015年的1.69%及2016年的1.65%比较,差异均有统计学意义(P<0.05);2014年HFMD病死率为0.06%,分别较2013年的0.01%和2015年的0高,并且差异均有统计学意义(P<0.05)。(2)2013年及2015年HFMD发病月份分布构成比中,均为9月所占比重最大,分别为30.90%及26.43%,而2014年及2016年则为5月所占比重最大,分别为28.59%及31.47%;2013年4月HFMD重症率为2.15%,2014年2月为5.34%,2015年3月为6.48%,2016年10月为5.50%,分别为当年每月HFMD重症率的最高值。(3)本研究HFMD患儿年龄分布以>1~3岁所占比重最大(57.47%),≤5岁患儿所占比重达94.96%;≤1岁患儿及>1~3岁患儿的HFMD重症率,均分别较>3~5岁及>5岁高,并且差异均有统计学意义(P<0.05)。(4)本研究HFMD患儿中,男性患儿占61.47%(28 149/45 793),男性患儿HFMD重症率为1.80%(508/28 149),较女性患儿1.27%(224/17 644)高,并且差异有统计学意义(χ~2=19.745,P<0.001);散居儿童、幼托儿童及学生的HFMD所占�Objective To study the clinical characteristics of children with hand,foot and mouth disease（HFMD）in Maternal Child Health Hospital of Guangxi Zhuang Autonomous Region.Methods A total of 45 793 children with HFMD in Maternal Child Health Hospital of Guangxi Zhuang Autonomous Region from January 1,2013 to December 31,2016,were selected as research subjects.After obtaining informed consents of all cases,throat swabs or（and）herpes fluid samples were collected from 363 mild type of HFMD cases,and throat swabs samples from 732 severe type of HFMD cases to detect enterovirus（EV）including EV71,coxsackievirus（Cox）A16 and other types of EV.Clinical data of all children with HFMD were analyzed retrospectively,and the characteristics of HFMD cases in our hospital from 2013 to 2016 were analyzed statistically including：（1）rates of severe type and fatality rates of HFMD in each year;（2）distribution characteristics of HFMD including months,ages,gender,crowd and region,and rates of severe type of HFMD of these factors;（3）etiologic characteristics of HFMD cases.The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Maternal Child Health Hospital of Guangxi Zhuang Autonomous Region.Results（1）Among 45 793 HFMD children,98.40%（45 061/45 793）of them were with mild type of HFMD,and 1.60%（732/45 793）were with severe type of HFMD.Fatality rate of children with severe type of HFMD was 1.64%（12/732）.In 2013,rate of severe type of HFMD（1.13%）was the lowest compared to that of 2014（1.85%）,2015（1.69%）and 2016（1.65%）,respectively,and all the differences were statistically significant（P〈0.05）.Fatality rate of children with HFMD in 2014（0.06%）was higher than that of 2013（0.01%）and 2015（0）,respectively,and all the differences were statistically significant（P〈0.05）.（2）Constituent ratio of HFMD monthly incidence：the most cases occurred in September in 2013 and 2015 with proportion of 30.90% and 26.43%,respectively,wh

关 键 词：手足口病 柯萨奇病毒感染 肠道病毒A型 人 儿童 

分 类 号：R725.1[医药卫生—儿科]