北京市儿童手足口病影响因素病例对照研究

Risk factors of hand-foot-mouth disease among children in Beijing city

目的了解北京市手足口病发病的危险因素,为进一步采取防控措施提供数据支持。方法 2010年6—9月,选择常住北京且临床诊断为手足口病的非重症患儿461例和未患过手足口病的儿童473名,采用成组匹配的病例对照研究,利用自制问卷,调查与先天免疫力有关的因素及后天养育习惯、生活水平等,采用SPSS 13.0对数据统计分析。结果罹患手足口病与和先天免疫力有关的因素关联程度均无统计学意义;就诊前10天内接触过类似症状者(OR=2.692,P<0.05)是危险因素,卫生习惯好(OR=0.763,P=0.055)、就诊前10天内去过医院(OR=0.587,P=0.005)、家中饲养猫(OR=0.339,P=0.035)、人均住房面积大(20～40 m2OR=0.466,P<0.05;≥40 m2OR=0.554,P=0.005)为保护因素;由于接触类似症状者而感染手足口病约占全部发病人数的62.85%。结论在北京市预防手足口病除隔离患儿外,重点应针对收入较低、住平房且面积较小的相对弱势群体,宣传改善各项卫生习惯,促进就医意识。

Objective To explore the risk factors of hand-foot-mouth disease（HFMD） in Beijing city and to provide reference for prevention of the disease.Methods A unified questionnaire was used to survey the innate immunity factors and acquired factors,including rearing pattern and living standard,related to HFMD.Statistical analyses were conducted with SPSS 13.0.Results No associations were observed between HFMD and innate immunity.Exposed to individuals with suspected symptoms within 10 days before the medical attendance（odds ratio =2.692,P0.05） was a risk factor.Healthy habits（OR=0.763,P=0.055）,having been to hospital within 10 days before the hospitalization（OR=0.587,P=0.005）,rearing cats at home（OR=0.339,P=0.035） and having larger living space（20-39 m2/per person：OR=0.466,P0.05;≥40m2/per person：OR=0.554,P=0.005） were protective factors.There were 62.85% of HFMD cases had been exposed to individuals with suspected symptoms.Conclusion Execpt the isolation of the children with HFMD,improvments of health habits and medical attendance consciousness in vulnerable children in low-income family,living in bungalow or limited living space are benificial to prevent HFMD in Beijing.