EV_(71)病毒感染儿童重症手足口病临床危险因素分析

Clinical risk factors of severe cases of hand,foot and mouth disease with EV_(71)virus infection in children

目的:探讨EV_(71)病毒感染儿童重症手足口病的临床危险因素。方法:将122例EV_(71)病毒感染的手足口病患儿分为重症组(53例)和轻症组(69例),根据相关因素及临床特征进行单因素分析后再采用Logistic回归分析的方法进行多因素分析。结果:入院时,重症组和轻症组患儿在精神差、心率快、呼吸急促、高热、恶心呕吐、肢体颤抖、血糖和血白细胞等方面进行比较,其差异均有统计学意义(P<0.05)。Logistic回归分析显示:精神差、心率快、高热、恶心呕吐及肢体颤抖是重症手足口病的危险因素(P<0.05)。结论:手足口病患者出现精神差,病程中伴有高热、恶心呕吐、心率加快和肢体颤抖等症状,需高度警惕为EV_(71)感染的重症手足口病,密切观察患儿病情,及时给予积极有效的治疗,有助于减少手足口病的病死率。

Objective： The primary objectives were to find clinical risk factors of severe hand-foot-mouth disease （HFMD） associated with EV71 infection.Methods： A retrospective clinical case-control study was conducted in 122 hand-foot-mouth disease patients to compare severe and mild cases of patients infected with the EV71 virus.For the significant variables found during univariate analysis, Multi-factorial logistic regression was used to analyze independent associations between potential risk factors and severe HFMD.Results： The results of univariate analysis on the onset of disease showed that risk factors for severe HFMD include reduced consciousness, tachycardia, Tachypnea, fever（＆gt;39.1℃）, sicchasia and vomiting, myoclonus, hyperglycemia, leukocytosis（P〈0.05）.The multi-factorial logistic regression revealed that the main risk factors for severe cases were reduced consciousness, tachycardia, fever （〉39.1℃）occurring before hospitalization, sicchasia and vomiting,myoclonus（P〈0.05）.Conclusion： The readily elicited clinical risk factors than were reduced consciousness, tachycardia, fever（〉39.1℃） occurring before hospitalization, sicchasia and vomiting,myoclonus were identified to help detect children at severe cases of hand, foot and mouth disease with EV71 virus infection.These risk factors may serve as a guide to clinicians to decide the need for hospitalization and further investigation and close monitoring for disease progression in children with HFMD.