重症手足口病危险因素研究

Research on risk factors of severe hand foot and mouth disease

目的探讨重症手足口病的危险因素,为今后开展该病防治工作提供科学依据。方法以北京市海淀区2010—2011年度发生的手足口病例为研究对象,选择重症病例(病例组)和普通病例(对照组)各56例,通过病例报告卡资料数据进行病例对照研究,采用单因素和多因素logistic回归分析探讨重症手足口病的危险因素。结果单因素分析显示,重症病例组和对照组在年龄、性别、病毒类型构成、初诊医院方面的差异无统计学意义(P>0.05),入园状态、就诊时间的构成比差异具有统计学意义(P<0.05),提示这些因素可能是感染重症手足口病的危险因素。多因素分析显示,影响重症手足口病的危险因素是入园状态、就诊时间、就诊医院(P<0.05),与户籍、年龄、感染病毒的类型无关(P>0.05)。结论托幼机构、学校、环境卫生状况等对重症手足口病的发生起重要影响。疾病预防控制机构应对家长和学校进行健康教育,发现可疑患者应及时就医,对该病无诊疗能力的医疗机构应对患儿及时转诊,避免贻误病情。

[ Objective] To explore the risk factors of severe hand foot and mouth disease （ HFMD ）, provide a scientific basis for future prevention and treatment against the disease. [ Methods ] HFMD cases occurred during 2010-2011 in Haidian District of Beijing were investigated. 56 severe cases （ the case group） and ordinary cases （ the control group） were selected, and the data of case re- port cards were used in the case-control study. The univariate and multivariate logistic regression was adopted to research the risk factors of severe HFMD. [ Results ] Univariate analysis showed that there were no significant differences in gender, age, virus type, the first-visited hospital between severe case group and the control group （ P 〉 0.05 ）. The differences in admission status and visit time were significant （ P 〈 0.05 ） , which indicated that they might be the risk factors of severe HFMD. Multivariate analysis showed that admission status, visit time, visited hospitals were the risk factors of severe HFMD （ P 〈 0.05 ） , and severe HFMD was not re- lated to household registration, age and virus type （P 〉 0.05 ）. [ Conclusion] The environmental health conditions of nurseries and schools have great impact on the occurrence of severe HFMD. Disease prevention and control institutions should conduct health education among parents and schools, and the suspicious patients should be treated promptly. The institutions without the capacity to diagnose and.treat the disease should transfer the patients to other hospitals, to avoid adverse effect by the illness.