重症手足口病病情进展相关因素分析  

Analysis of the factors associated with the progression of mild hand-foot-mouth disease to severe disease

作　　者：刘艳菊[1] 张娜[1] 史红波[1] 张凤娟 刘德辉[2] 胡林 聂清[2] LIU Yanju;ZHANG Na;SHI Hongbo;ZHANG Fengjuan;LIU Dehui;HU Lin;NIE Qing(Infection Disease Department,Weifang People's Hospital,Weifang 261041,China;Laboratory of Microbial,Weifang Center for Disease Control and Prevention)

机构地区：[1]潍坊市人民医院感染性疾病科,山东潍坊261041 [2]潍坊市疾病预防控制中心

出　　处：《潍坊医学院学报》2023年第4期288-292,共5页Acta Academiae Medicinae Weifang

基　　金：潍坊市卫健委计划项目(项目编号:wfwsjk_2019_120)。

摘　　要：目的分析手足口病重症病例病情进展相关因素。方法收集2019年~2020年期间收治的手足口病(HFMD)患者(轻症29例,重症43例)及2009年~2018年期间的6例危重症病例的临床资料;采集患者血清样本进行临床常规检测,粪便或肛拭子样本利用RT-PCR法进行病原学鉴定,采用SPSS20.0统计学软件进行数据分析。结果2019年前收集的17例重症病例中,EV-A71占比(70.6%)最高,2019年~2020年期间收治的所有病例均为CV-A16感染;发热最高温度、住院天数、心动过速、舒张压、WBC数量、中性粒细胞数量、血糖、发热天数在轻症及重症患儿间的差异均有统计学意义(P<0.05);照顾者受教育年限间差异有统计学意义(P<0.05);两组患儿出疹部位均以口首发为主(轻症:65.5%;重症:42.9%),出疹类型均以斑丘疹型为主(轻症:55.2%;重症:57.1%);所有重症患儿均有脑炎症状,所有神经系统症状两组间差异有统计学意义(P<0.05)。结论发热最高温度、口首发、高血糖、住院天数、舒张压、心动过速为手足口病例病情进展的危险因素;恶心、照顾者受教育年限长是保护因素。Objective To investigate the correlative factor that promote mild to severe hand-foot-mouth disease.Methods The clinical datum of HFMD patients(including 29 mild cases and 43 severe cases)from 2019 to 2020 and 6 critical patients from 2009 to 2018 were collected.The serum samples were used for routine clinical testing.The feces or anal swabs for pathogenic identification by RT-PCR,SPSS 20.0 statistical software was used to analyze the datum.Results All the cases collected from 2019 to 2020 were infected with CV-A16;The differences of the highest fever temperature,hospitalization days,tachycardia,diastolic blood pressure,WBC number,neutrophil number,blood sugar and fever days between mild and severe cases were statistically significant(P<0.05);There was a significant difference between mild and severe cases in the years of caregiver's education(P<0.05);The main eruption parts of two groups were all in the mouth(mild cases:65.5%;severe cases:42.9%),and the eruption type were all maculopapular;All severe cases developed onset encephalitis,and all neurologic symptoms between two groups were statistically significant(P<0.05).Conclusion The risk factors of severe HFMD are the highest tempreture,the eruption in mouth,high blood sugar,hospitalization days,diastolic pressure and tachycardias,but nausea and the education level of caregiver are protective factors.Belonged hospitalization due to illness may be the unfavorable factors for the development of HFMD.

关 键 词：手足口病 轻症 重症 临床特征 影响因素 

分 类 号：R725.1[医药卫生—儿科]