手足口病发病影响因素病例对照研究

Influencing factors of hand-foot-mouth disease in Baoshan district:a case-control study

目的探讨手足口病发病的主要危险因素,分析重症病例特征。方法选取上海市宝山区2010年1月1日-6月10日手足口病病例133例,分重症管理病例和普通病例,采用配对病例对照研究方法,进行发病与重症影响因素分析。结果单因素分析显示,手足口病发病影响因素有户籍、早产、体质弱、通风情况、居住环境卫生、病例接触史、家长手足口防病知识得分和饭前洗手,OR值分别为1.564、2.019、1.995、1.987、2.545、1.986、3.019、和0.757;多因素分析显示,手足口病发病影响因素为早产、体质弱、居住环境卫生差和有病例接触史4个因素,其OR值分别为2.550、1.243、2.907和2.330;重症病例与普通病例比较,在年龄、户籍、房屋采光、发病距就诊时间间隔上差异有统计学意义(P<0.05)。结论早产、体质弱、居住环境卫生差和病例接触史是手足口病发病的危险因素;感染病毒类型为EV71、患儿年龄偏小、户籍为外来人口、居住房屋采光通风差以及就诊距发病间隔时间长是引起重症的可疑因素。

Objective To understand the risk factors of hand-foot-mouth disease（HFMD） and to analyze the features of severe cases in Baoshan district. Methods A questionnaire survey was used to obtain information in the case-control study and conditional logistic regression model was used in univariate and multivariate analyses. Results The results of univariate analysis showed that household,premature delivery,poor health status,ventilated circumstance,residence environment,history of contacting with HFMD patients,the score of the parents getting HFMD prevention knowledge,and washing hands before dining were related to HFMD with the odds ratio（OR） values of 1.564,2.019,1.995,1.987,2.545,1.986,3.019,and 0.757,respectively.The results of multivariate analyses showed that premature delivery,poor health status,poor residence environment,and history of contacting with HFMD patient were significantly related to HFMD with the OR values of 2.550,1.243,2.907,and 2.332,respectively. Conclusion Premature delivery,poor health status,poor residence environment,and history of contacting with HFMD patient may be risk factors of HFMD.Type of virus EV71 infection,young children,floating population,poor ventilation and lighting of residence,and long time from the onset of the diease to seeing a doctor are risk factors of severe HFMD.