我国学龄前儿童手足口病影响因素的Meta分析

Meta-Analysis on Influence Factors of Hand-Foot-Mouth Disease of Preschool Children in China

目的探讨当前我国学龄前儿童手足口病(HFMD)的主要影响因素,为其防治提供科学依据。方法采用国际Cochrane组织推荐的Meta分析软件Rev Man 4.2,对2008年至2014年国内已发表的有关我国学龄前儿童手足口病影响因素的病例对照研究进行Meta分析。结果经异质性分析后,分别采用固定效应模型和随机效应模型进行OR值合并,并计算其95%可信区间。Meta分析结果表明,近期有接触HFMD患者史(OR=3.43,P<0.01)、为流动人口(OR=1.77,P<0.01)、城乡类型为农村(OR=2.20,P=0.03)、近期外出暴露史(OR=1.69,P<0.01)、与其他儿童共用玩具(OR=2.48,P<0.01)为我国学龄前儿童HFMD患病的危险因素,饭前洗手(OR=0.59,P<0.01)、主要照顾者文化程度高(OR=0.39,P=0.02)、近期有医院门诊暴露史(OR=0.58,P<0.01)为保护因素,而性别(OR=0.98,P=0.90)、家中儿童数>1(OR=1.28,P=0.24)与其发病无统计学意义。结论我国学龄前儿童手足口病患病的影响因素较多,应从多方面进行预防控制。

Objective To study the main influence factors of hand-foot-mouth disease （HFMD） of preschool children in our country, and to provide a scientific basis for the prevention and treatment of HFMD. Methods Case-control studies on influence factors of hand-foot-mouth diseases about preschool children in our country, published in year 2008 to 2014, were analyzed by Meta analysis software RevMan 4.2 recommended by the international Cochrane organization. Results After heterogeneity analysis, fixed effect model and random effect model were used to merger OR and calculate the 95% confidence interval. Meta analysis results showed that contacting with HFMD cases recently （OR = 3.43, P〈0.01）, the floating population （OR = 1.77, P〈0.01）, rural areas （OR = 2.20, P= 0.03）, the recent outside exposure history （OR = 1.69, P 〈0.01） and sharing toys with other children （OR = 2.48, P 〈0.01） were risk factors for our country preschool children. Washing hands before dinner （OR = 0.59, P 〈0.01）, the high cultural degree of main caregivers （OR = 0.39, P = 0.02） and the exposure history of hospital and outpatient clinic （OR = 0.58, P〈0.01） were protective factors. Sex （OR = 0.98, P= 0.90） and the number of children in the home 〉 1 （OR = 1.28, P= 0.24） had no statistical significance. Conclusions The influence factors of preschool children in our country are various, so comprehensive measures should be taken to reduce the incidence rate.