重症手足口病患儿临床特征与血液脑脊液EV71-IgM结果的相关性分析

目的探讨重症手足口病患儿的临床特征与血、脑脊液EV71-IgMkL体的相关性，为早期识别危重型手足口病患儿提供更多依据。方法回顾性分析2014年3月1日至7B31目手足口病高发期间收治的317例重症手足口病患儿的一般临床资料和血、脑脊液EV71-tgM抗体及相关实验室检测结果，对两组结果进行分析比较。结果317例重症手足口病患儿中，重型264例（83．3％），危重型53例（16．7％）。危重型组与重型纽在年龄、体重、脑脊液氯含量及肢体抖动方面差异均有统计学意义（P〈0．05）；危重型患儿的血清EV71阳性率（84．9％）高于重型组患儿（76．5％），但差异无统计学意义（P〉0．05）；危重型患儿的脑脊液EV71阳性率（50．9％）略低于重型组（53．8％），差异亦无无统计学意义（P〉O．05）。结论绝大部分重症病例由EV71感染引起，与血清及脑脊液EV71-IgM抗体阳性率无相关性，但年龄越小、体重越轻、脑脊液氯含量减少及肢体抖动明显的重症手足口病患儿，越容易向危重型发展。

Objective To provide more evidence for early identification of severe hand-foot-and-mouth disease （ HFMD ） , via investigating the correlation between clinical characteristics and the EV71-IgM antibody in serum and cerebrospinal fluid （ CSF ） of severe HFMD pediatric patients. Methods The clinical data of 317 cases with severe hand foot mouth disease from March 1, 2014 to July 30th, 2014 were retrospectively analyzed, and the blood and cerebrospinal fluid EV71-IgM antibody and related laboratory test results were analyzed. The results of the two groups were analyzed and compared. Results A large study of 317 cases was performed and 264 cases （ 83.3% ） were severe, 53 cases （ 16.7% ） were critical. The content of cerebrospinal fluid C1-, age, weight, incidence of limb jitter were significant difference （P〈0.05） . The positive rate of serum EV71 in pediatric patients with critical HFMD （84.9%） was higher than that in severe group （77.1%） , but the difference was not found to be statistically significant （ P〉0.05 ） . The positive rate of CSF EV71-1gM in pediatric patients with critical HFMD （ 50.9% ） was a little lower than that in severe group （ 53.8% ） , the difference was no statistically significant （ P〉0.05 ） . C0ndusion Severe cases are mostly caused by EV71. The positive rate of EV71- IgM in cerebrospinal fluid or serum was not found to be significant for the identification of critical HFMD, but the younger the age, the lighter weight, the decrease ofcerebrospinal fluid Cl- and the high incidence of limb jitter, the higher the possibility of patients to develop into fatal cases.