株洲地区重症手足口病患儿临床与实验室特点

Clinical and laboratory features of severe hand-foot-and-mouth disease in children in Zhuzhou

目的探讨重症手足口病（HFMD）患儿的临床及实验室检查特点。方法回顾性分析某院2010年310月收治的80例重症HFMD患儿资料，并选择同期住院的98例轻症HFMD患儿病历信息进行对比分析。结果80例重症HFMD患儿平均年龄为（18．52±3．23）个月，〈3岁者70例（87．50％）；均发热，伴持续高热36例（45．00％），重症肺炎10例（12．50％），神经系统损害70例（87．50％），血压升高42例（52．50％）；病原学检查肠道病毒71型阳性73例（91．25%）；外周血平均白细胞计数为（14．24±3．87）×10^9／L，平均血糖值为（8．45±1．21）mmol／L；心肌酶CK-MB升高71例（88．75％），平均CK-MB值为（69．71±18．26）IU／L。与轻症组患儿比较，上述差异均有统计学意义（P〈O．01）。结论重症HFMD患儿发生持续高热、神经系统损害较多。对年龄小、热程长、嗜睡、高白细胞计数、高血糖、高血压的HFMD患儿应警惕发展为重症。

Objective To evaluate clinical and laboratory features of children with severe hand-foot-and-mouth disease（HFMD）. Methods Data of 80 severe HFMD patients diagnosed and treated in a hospital from March to October 2010 were analyzed retrospectively, and compared with 98 mild HFMD cases over the same period of hospitalization. Results Of 80 severe HFMD children, the average age were （18. 52 ± 3.23） months, 70 （87. 50%） were〈3 years old; all patients had fever,36 cases （45.00%） were with persisten high fever; 10 （12. 50%） were with severe pneumonia,70 （87. 50%） had nervous system damage,42 （52. 50%） had increase in blood pressure ; 73 （91.25%） were with positive enterovirus 71; average peripheral blood white blood ceil count were （14. 24 ± 3.87） × 10^9/L, average blood glucose were （8.45 ± 1. 21） mmol/L; 71 cases （88. 75%） had increased enzyme CK-MB, the average value of CK-MB were （69. 71 ± 18. 26） IU/L, there were significant difference compared with mild cases （P〈 0. 0l）. Conclusion Severe HFMD children can easily develop persistent high fever, and nervous system damage. HFMD children with small age, long course of fever, sleepiness, high white blood cell count, hyperglycemia, and hypertension are more prone to become severe HFMD and should be paid attention.