北京市2012年手足口病病原学监测重症病例危险因素分析

Risk factors associated with etiological severe cases of Hand-foot-mouth disease in Beijing, 2012

目的 分析北京市2012年手足口病病原学监测数据,了解北京市手足口病重症病例分布特征及危险因素,为调整防制策略提供依据.方法 对北京市18个区县疾控中心上报的手足口病病原学数据进行统计,采用现况研究的方法,利用EXCEL录入数据库,将所有病原学监测阳性病例分为重症病例组和轻症病例组,运用SPSS17.0软件分析患儿进展为重症病例的影响因素及因素间交互作用.结果 单因素分析中,年龄、居住地、是否为托幼儿童及EV71阳性对病例是否进展为重症病例有影响.多因素分析显示,年龄≤3岁（OR =4.58,95％CI 2.90 ～ 7.09）、散居儿童（OR =2.7,95％CI 1.72 ～4.26）、流行季病例（OR=2.46,95％CI 1.40 ～4.34）、居住地为郊区病例（OR=5.84,95％ CI 2.33～14.63）及EV71阳性（OR=2.77,95％CI 1.94 ～3.98）为手足口病例进展为重症病例的危险因素.交互作用分析显示居住地与年龄和看护类型、看护类型与性别、EV71与年龄和看护类型对于是否重症存在协同作用.结论 年龄≤3岁、居住在郊区、EV71阳性为手足口病例进展为重症病例的危险因素.

Objective To provide basis for the prevention of HFMD, we analyzed the data of 2012 HFMD etiology monitoring, and to find the characteristics and risk factors of HFMD severe cases in Beijing. Methods The data of 2012 HFMD etiology monitoring was analyzed by the method of cross-sectional study. We divided the positive cases into two groups （the severe cases group and the mild cases group）. Excel 2007 was used to set up database, SPSS 17.0 was used to carry out statistical analysis. Results Single-fac- tor analysis showed that age, place of residence, kindergarten child or not （ diaspora pattern） , and EV71 in- fection had influence on severe cases. In the study, the multivariate logistic regression revealed that ~〈 3 years old, diaspora pattern, prevalence season, living in suburb and EV71 infection were risk factors of HFMD severe cases. Interaction analysis showed that there were interactions between living place, age, and diaspora pattern, interactions also existed between diaspora pattern and gender, and it was the same to EV71 infection and diaspora pattern. Conclusions ≤ 3 years old, scattered children, resident suburb, and EV71 infection are risk factors of HFMD severe cases.