影响重症肠道病毒71型感染手足口病患儿并发脑炎的相关因素回归分析

Regression Analysis of Factors Associated with Severe Enterovirus 71 Infection Affecting Children with Hand,Foot and Mouth Disease Complicated by Encephalitis

目的:探讨影响重症肠道病毒71型(EV71)感染手足口病患儿并发脑炎的相关因素,有利于缓解患儿病情进展程度,改善预后,降低其死亡风险。方法:回顾性分析2015年1月—2022年1月惠州市第一妇幼保健院收治的148例EV71感染手足口病患儿临床资料,以是否并发脑炎,将并发脑炎患儿分为研究组(n=66),未并发脑炎患儿分为对照组(n=82)。采用logistic回归模型分析患儿并发脑炎与性别、年龄、精神状态、神经反射异常、呼吸道感染、口腔溃疡、白细胞(WBC)计数、肌酸激酶同工酶(CK-MB)水平及淋巴细胞计数的关系。结果:logistic回归分析结果显示,呕吐(OR=3.441)、空腹血糖(升高)(OR=1.811)、体温≥39℃(OR=4.933)、呼吸异常(OR=14.055)、肢体抖动(OR=7.478)、频繁惊跳(OR=10.935)、呼吸道感染(OR=4.845)及淋巴细胞计数升高(OR=5.280)是导致重症EV71感染手足口病患儿并发脑炎的独立危险因素。结论:呕吐、空腹血糖(升高)、体温≥39℃、呼吸异常、肢体抖动、频繁惊跳、呼吸道感染及淋巴细胞计数升高是影响重症EV71感染手足口病患儿并发脑炎的独立危险因素,可由此采取相应措施以降低患儿并发脑炎的风险。

Objective:To investigate the factors affecting the complications of encephalitis in children with severe enterovirus 71(EV71)infection of hand,foot,and mouth disease,which will help to alleviate the degree of progression,improve the prognosis,and reduce the risk of death in children.Methods:The clinical data of 148 children with EV71 infection of hand,foot and mouth disease admitted to the hospital from January 2015 to January 2022 were retrospectively analyzed,and children with concurrent encephalitis were divided into a study group(n=66)and children without concurrent encephalitis were divided into a control group(n=82),based on whether they had concurrent encephalitis.A logistic regression model was used to analyze the relationship between children with concurrent encephalitis and gender,age,mental status,abnormal neurological reflexes,respiratory tract infection,oral ulcers,white blood cell(WBC)count,creatine kinase isoenzyme(CK-MB)level and lymphocyte count.Results:Logistic regression analysis showed that vomiting(OR=3.441),fasting glucose(elevated,OR=1.811),temperature≥39℃(OR=4.933),abnormal breathing(OR=14.055),limb tremors(OR=7.478),frequent startle(OR=10.935),respiratory tract infection(OR=4.845)and elevated lymphocyte count(OR=5.280)were independent risk factors for encephalitis in children with severe EV71-infected HFMD.Conclusion:Vomiting,fasting glucose(elevated),temperature≥39°C,abnormal respiration,limb tremors,frequent startle,respiratory tract infection and elevated lymphocyte count are independent risk factors affecting children with severe EV71-infected HFMD with complications of encephalitis,which may lead to appropriate measures to reduce the risk of complications of encephalitis in children.