重症手足口病患儿早期临床表现及高危因素分析

Early clinical manifestations and risk factors analysis in children with severe hand-foot-mouth disease

目的探讨重症手足口病患儿的早期相关高危因素及在病情评估中的意义,指导临床及早干预,提高救治水平。方法回顾性分析2011年2—11月收治的手足口病重症患儿46例(重症组)和普通型患儿79例(普通组)发病48 h内的早期临床表现,并进行对比研究。结果两组患儿年龄、热程大于6 h,发病48 h内神经系统表现,血糖、C-反应蛋白(CRP)、乳酸脱氢酶(LDH)及肌酸激酶同工酶(CK-MB),肠道病毒71型(EV71)阳性等方面比较,差异有统计学意义(P<0.05),而呼吸、心率、血压、出冷汗、肺部啰音、毛细血管再充盈时间(CRT)、白细胞计数、免疫球蛋白、胸部X线片异常差异无统计学意义(P>0.05)。结论早期出现神经系统表现,年龄小于3岁,热程大于6 h,血糖、CRP、LDH及CK-MB升高,EV71感染是重症手足口病早期高危因素。

Objective To analyze the early risk factors in critically ill children with hand-foot-mouth disease（HFMD） and their significance to the evaluation of disease condition for guiding the clinical early intervention and improving the level of treatment. Methods The retrospective investigation was performed on the early clinical manifestations in 46 cases of severe HFMD and 79 cases of ordinary type HFMD in the pediatrics and infection departments of our hospital from February to Novem- ber 2011 and the comparative research was conducted. Results Comparing the two groups, age, fever duration of more than 6 h, nervous system manifestations within onset 48 h, glucose, CRP, LDH and CK-MB increase and positive EV71 showed statistical differences （P〈0.05）, and respiration, heart rate, blood pressure, cold sweating, chest rales, CRT, WBC counts, immunoglobulin and abnormal chest radiograph showed no statistical differences （P〉0.05）. Conclusion Early neurological manifestations,age less than 3 years ,fever duration more than 6 h,inceeased glucose,CRP,LDH and CK-MB, and EV71 infection are the early risk factors of severe HFMD.