446例轻症和重症手足口病指标分析和预警价值  

Warning value of laboratory indicators in 446 cases of mild and severe hand,foot,and mouth disease

作　　者：刘卫红[1] LIU Wei-hong(Second Department of Pediatrics,Pingdingshan First People′s Hospital,Pingdingshan,Henan 467000,China)

机构地区：[1]平顶山市第一人民医院普儿二科

出　　处：《现代预防医学》2019年第11期2070-2075,共6页Modern Preventive Medicine

摘　　要：目的探讨手足口病(HFMD)的临床特征以及治疗前后临床指标的变化。方法回顾分析2015年1月到2017年4月确诊的446例HFMD患者,单因素logistic回归分析HFMD患儿轻重症因素,并建立多因素logistic回归模型,采用受试者工作特征(ROC)曲线下面积(AUC)综合评价。结果重症与轻症的HFMD的单因素比较和logistic回归分析结果显示,在21项检测指标中,其中血小板、肌酐、尿酸和超敏C反应蛋白四项指标有统计学意义(P<0.001),其ROC曲线显示AUC分别为0.657、0.653、0.666、0.679。这4项指标联合检测预测重症手足口病的AUC为0.728(95%CI:0.681~0.775),诊断价值优于单一指标。结论肌酐、血小板、尿酸和超敏C反应蛋白可以提示HFMD的严重程度,区分病情的轻重情况。此外,四项指标联合诊断检测优于单一指标,值得临床重视和应用。Objective To investigate the clinical characteristics of hand,foot,and mouth disease(HFMD)and the changes in clinical indicators before and after treatment.Methods 446 patients with HFMD were retrospectively analyzed from January 2015 to April 2017.Single-factor logistic regression analysis was used to analyze the risk factors for children with mild and severe HFMD,and the multivariate logistic regression model was also established.The receiver operating characteristic curve(ROC)and the corresponding area under the ROC curve(AUC)were used for comprehensive evaluation.Results Univariate and multivariate logistic regression analyses of risk factors for mild and severe HFMD showed that among 21 indexes,platelet(PLT),creatinine(CR),uric acid(UA)and high-sensitivity C protease(CRP)were statistically significant(P<0.001).ROC analysis showed that the AUC of these four indicators were 0.657,0.653,0.666,and 0.679,respectively.AUC of the combination of these four indicators to predict severe HFMD was 0.728(95%CI:0.681-0.775),which was of better diagnostic value than the single indicator.Conclusion PLT,CR,UA and CRP can indicate the severity of HFMD,and the combined detection of these four indicators is superior to the diagnosis value of a single indicator,which is worthy of clinical attention and application.

关 键 词：手足口病 轻症 重症 临床特征 ROC曲线 

分 类 号：R181.8[医药卫生—流行病学]