重症手足口病并神经源性肺水肿及死亡相关危险因素分析

Relative Risk Factors Analysis of Sever Hand Foot and Mouth Disease with Neurogenic Pulmonary Edema and Death

目的探讨重症手足口病并神经源性肺水肿以及最终死亡的临床相关因素。方法比较其症状、体征、检验、病原学结果等单个因素,分别分析发生神经源性肺水肿可能的危险因素和出现神经源性肺水肿后死亡可能的危险因素。结果 238例中,合并神经源性肺水肿67例,发生率28.15%,在合并神经源性肺水肿组中死亡45例,死亡率67.16%。结论手足口病并神经源性肺水肿的相关因素可能有血压升高、心率增快、白细胞升高、血糖升高;手足口病并神经源性肺水肿后死亡的相关因素可能有乳酸水平、BNP、PCLS、循环衰竭。交感神经衰竭导致循环衰竭是死亡的最终途径。

Objective To evaluate the risk factors with the severe hand foot and mouth disease（HFMD）with neurogenic pulmonary edema（NPE）and death, which aims to be a guideline of early awareness,treatment and reduce mortality.Methods Single factor to compare their symptoms,signs,test, results of etiology,risk factors were analyzed possible neurogenic pulmonary edema after possible risk factors and the emergence of neurogenic pulmonary edema and death. Results Of 238 cases,the merger neurogenic pulmonary edema in 67 cases,the incidence of 28.15%,45 cases of death in the consolidated group of neurogenic pulmonary edema,mortality 67.16%. Conclusion The possible risk factors of HFMD with NPE are hypertension and tachycardia, leukocytosis,hyperglycemia;the risk factors of HFMD with neurogenic pulmonary edema are lactic acid level,BNP,PCLS,circulatory failure. Sympathetic failure leading to circulatory failure is the final pathway to death.