EV71感染重症病例的临床表现及流行病学特征分析

Analysis on clinical and epidemiological characteristics of severe cases infected by EV71

目的 探讨EV71感染的重症手足口病病例的临床及流行病学特征,为手足口病的防治提供科学依据.方法 查阅病历,填写个案调查表,应用Epidata录入数据,SAS9.13软件进行统计分析.结果 共调查201人,3岁以下者占84.65%,最小年龄5个月,最大8岁,男女比为2.2∶1;散居儿童占85.08%;农村发病51.74%,城市28.36%,城乡结合部19.90%;发病后1～4 d 81.59%发展成重症;发热和出疹分别占100%和99.95%,96.52%患儿伴有神经系统症状;病毒性脑脊髓脑炎、肺炎以及呼吸衰竭是主要的并发症;98.01%的患儿痊愈或好转.结论 3岁以下患儿是高危人群,农村和城乡结合部是防治重点,发病后1～4 d是预防并发症的关键期.

Objective To explore the clinical and epidemiological characteristics of serious cases of hand-foot-and-mouth disease （HFMD） infected by EV71, in oreder to provide scientific evidence for prevention and control of HFMD. Methods Information was collected by questionaires through consulting medical cases. Data was input by Epidata, and analysed by software SAS 9. 13. Result 201 severe cases were investigated. 84. 65% of the cases were below 3 years old. The youngest one was 5 months and the oldest one was 8 years old. The ratio for male and female was 2.2： 1. 85.08% of the cases were distributed sporadically. 51.74% of them lived in rural, 29. 36% of them lived in urban and 19.9% of them lived at the fringe area of rural and urban. 81.59% of the cases became serious between 1 and 4 days after infected.100% cases had fever and 99. 95% of them had a rash. 96. 52% of them had nerve system symptoms. The main complications were virulent spinal encephalitis, pneumonia and breathing exhaustion. 98.01% of the patients were recovered or cured. Conclusion The cases aged below 3 years old are high risk persons.Rural area and the fringe area of rural and urban are the key area for disease control. 1-4 days after onset is the key period to prevent complications.