不同临床类别手足口病危险因素分析

Risk factors of hand foot and mouth disease with different clinical features

目的了解不同临床类别手足口病危险因素,为手足口病防控提供科学依据。方法收集2009年3月至2010年4月浙江省手足口病疫情资料,轻症、重症与死亡病例个案资料,以及手足口病实验室检测结果,使用SPSS13.0软件进行分析。结果散居儿童、流动人口、居住在农村或城乡结合部、病前7天去过接种门诊,以及患者家14岁以下儿童数多是重症病例的危险因素。死亡病例的危险因素是初诊医院级别低、误诊率高和由祖父母照顾。重症、死亡病例的实验室检测结果以EV71为主。结论重症手足口病主要发生在散居儿童、流动人口、居住在农村和城乡结合部的人群,病前去过接种门诊和家庭儿童数多是危险因素,而死亡病例的初诊医院级别较低、误诊率高,祖父母照顾比例高。EV71是重症、死亡病例的主要病原体。

Objective To understand the risk factors of hand foot and mouth disease with different clinical features,and provide scientific evidence for the disease control.Methods The epidemic data of HFMD,the data of mild,severe and death cases of HFMD in Zhejiang from March,2009 to April,2010 were collected to conduct analysis by using SPSS 13.0 software.Results The risk factors of severe cases of HFMD included children being outside child care settings,being floating population,living in rural area or outskirt,going to vaccination clinic 7 days prior to the onset and family with multichildren aged ≤14 years.The risk factors of death cases included the first medical care seeking in low grade hospital,high misdiagnosis rate and children being reared by grandparents.Most severe and death cases were detected to be EV71 positive.Conclusion Severe cases mainly occurred among children outside child care settings,in floating population and living in rural area or outskirt with the risk factors of going to vaccination clinic before the onset and family with multichildren.Most deaths were due to the misdiagnosis at low grade hospitals,and many of these children were reared by their grandparent.EV71 was the major pathogen to cause severe and death cases of HFMD.