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 high risk factors of children with severe hand-foot-mouth disease

目的探讨手足口病患儿并发中枢神经系统损害的高危因素。方法回顾性分析调查2011年2月至2012年5月河源市人民医院确诊的手足口病52例重症患儿和113例普通型患儿48 h内的早期临床表现。结果两组患儿比较,年龄、热程、发病48 h内神经系统表现、血糖、外周血白细胞计数、肌酸激酶同工酶CK-MB、EV71阳性、脑电图异常差异有统计学意义(P<0.05),而性别、呼吸、心率、血压、肺部啰音、毛细血管再充盈时间比较差异无统计学意义(P>0.05)。Logistic回归多因素分析示早期神经系统表现、血糖升高、EV71阳性是重症手足口病并发中枢神经系统损害的高危因素。结论早期出现神经系统表现、血糖升高、EV71感染是重症手足口病早期高危因素。

Objective To investigate the high risk factors of central nervous system damage in children with severe hand-foot- month disease （HFMD）. Methods From February 2011 to May 2012, the early clinical manifestations of children with HFMD, including 52 severe cases and 113 mild cases within 48 hours were retrospectively analyzed in the people＇s hospital of Heyuan. Results There were significant differences in age, duration of fever, neurological manifestations within 48 hours, blood glucose, peripheral leucocyte count, CK-MB, EV71 positive, abnormal electroencephalogram between the two groups （ P 〈 0. 05 ）. But there were no significant differences in gender, respiration, heart rate, blood pressure, pulmonary rales, CRT（P 〉 0.05 ）. Lo- gistic regression analysis showed that early neurological manifestations, increased blood glucose levels, positive EV71 were high risk factors of severe hand-foot-mouth disease complicated with central nervous system damage. Conclusion Early neurological manifestations, increased blood glucose levels, EV71 infection are the high risk factors of severe hand-foot-mouth disease.