手足口病并发急性下呼吸道感染临床研究

Clinical Research of Hand-foot-mouth Disease Complicated with Acute Lower Respiratory Tract Infection

目的探讨手足口病（HFMD）并发急性下呼吸道感染的临床特征。方法对117例并发急性下呼吸道感染的HFMD（观察组）与1 008例同期未并发急性下呼吸道感染的HFMD（对照组）住院患儿临床资料进行回顾性分析。结果 HFMD并发急性下呼吸道感染发生率为10.40%,为小儿HFMD常见的并发症（主要是支气管炎、喘息性支气管炎和肺炎）。①观察组病例中年龄以1-3岁、发病月份以10-12月多发,与对照组比较,差异有统计学意义（P〈0.05）。②观察组病例中绝大多数有发热（112例,95.73%）,所有病例均有咳嗽,伴有喘息6例（5.13%）,气促22例（18.80%）。③观察组贫血多见,与对照组比较,差异有统计学意义（P〈0.05）。④观察组胸片改变表现为肺纹理增粗、紊乱及点片状阴影。结论急性下呼吸道感染为HFMD常见并发症,其临床呼吸道症状明显,但重症患儿少见,以1-3岁幼儿、10-12月份多发,病原以肠道病毒（包括EV71）感染为主,合并支原体感染亦较为多见。

Objective To explore the clinical features of hand-footmouth disease（HFMD） complicated with acute lower respiratory tract infection. Methods We retrospectively analyzed clinical data of 117 hospitalized children with HFMD and acute lower respiratory tract infection（respiratory tract infection group） and 1,008 hospitalized HFMD children without acute lower respiratory tract infection（control group）. Results The incidence rate of HFMD children complicated with acute lower respiratory tract infection was 10.4%.Bronchitis,asthmatic bronchitis and pneumonia were the most frequent complications in HFMD children.Among respiratory tract infection group,most of the cases were the children aged 1～3 years,and the high incidence period was from October to December;there were statistically significant differences between respiratory tract infection group and control group（P〈0.05）.Among the 117 cases of respiratory tract infection group,112 cases had fever（95.73%）.All cases had cough,6 cases had wheeze（5.13%）,and 22 cases had breathlessness（18.80%）.Most of the children in respiratory tract infection group had anemia,there were statistically significant differences between respiratory tract infection group and control group（P〈0.05）.The changes of the chest radiograph in respiratory tract infection group were texture shadows,disorders and some flakes. Conclusions The acute lower respiratory tract infection was the most frequent complication of HFMD.The respiratory symptoms were obvious,but the severe case was seldom seen.Most of the cases were the children aged 1~3 years,and the high incidence period was from October to December.The major pathogen was enterovirus,including EV71.Enterovirus complicated by mycoplasma infection occurred frequently,too.