中华传染病杂志
中華傳染病雜誌
중화전염병잡지
CHINESE JOURNAL OF INFECTIOUS DISEASES
2008年
7期
387-390
,共4页
毛国顺%罗玲%刘晓琳%王丽春%刘利锋%邱志峰%韩扬%赵永%朱颖%谢静%李琦涵%李太生
毛國順%囉玲%劉曉琳%王麗春%劉利鋒%邱誌峰%韓颺%趙永%硃穎%謝靜%李琦涵%李太生
모국순%라령%류효림%왕려춘%류리봉%구지봉%한양%조영%주영%사정%리기함%리태생
肠道病毒71型%手足口病%肺水肿%脑炎%预测
腸道病毒71型%手足口病%肺水腫%腦炎%預測
장도병독71형%수족구병%폐수종%뇌염%예측
Enterovirus 71%Hand,foot,and mouth disease%Pulmonary edema%Encephalitis%Prediction
目的 比较2008年安徽省阜阳市手足口病流行中轻症与重症患儿的差异,探讨早期鉴别重症患儿的预警因子.方法 收集2008年3月7日至5月3日在安徽省阜阳市第一人民医院收治的41例临床诊断为手足口病患儿的完整资料,其中轻症组11例, 脑炎组15例,肺水肿组15例,比较3组患儿症状、体征、实验室检查、淋巴细胞表型特点及临床转归情况.结果 肺水肿组病死率为66.7%,较脑炎组显著升高.肺水肿组及脑炎组中年龄小于3岁者达93.3%,与轻症组比较差异有统计学意义.肺水肿组WBC及中性粒细胞数较轻症组显著升高(P<0.05).肺水肿组呼吸频率、心率、血糖水平显著高于脑炎组(P<0.05).脑炎组和肺水肿组患儿T细胞、NK细胞比例较轻症组均显著降低.结论 手足口病患儿出现肺水肿提示预后不良.年龄小于3岁患儿易出现重症,外周血WBC及中性粒细胞增高、呼吸增快、心率增快、血糖升高可能是病情进展的预测因素.T细胞亚群的检测有利于手足口病轻、重症的鉴别.
目的 比較2008年安徽省阜暘市手足口病流行中輕癥與重癥患兒的差異,探討早期鑒彆重癥患兒的預警因子.方法 收集2008年3月7日至5月3日在安徽省阜暘市第一人民醫院收治的41例臨床診斷為手足口病患兒的完整資料,其中輕癥組11例, 腦炎組15例,肺水腫組15例,比較3組患兒癥狀、體徵、實驗室檢查、淋巴細胞錶型特點及臨床轉歸情況.結果 肺水腫組病死率為66.7%,較腦炎組顯著升高.肺水腫組及腦炎組中年齡小于3歲者達93.3%,與輕癥組比較差異有統計學意義.肺水腫組WBC及中性粒細胞數較輕癥組顯著升高(P<0.05).肺水腫組呼吸頻率、心率、血糖水平顯著高于腦炎組(P<0.05).腦炎組和肺水腫組患兒T細胞、NK細胞比例較輕癥組均顯著降低.結論 手足口病患兒齣現肺水腫提示預後不良.年齡小于3歲患兒易齣現重癥,外週血WBC及中性粒細胞增高、呼吸增快、心率增快、血糖升高可能是病情進展的預測因素.T細胞亞群的檢測有利于手足口病輕、重癥的鑒彆.
목적 비교2008년안휘성부양시수족구병류행중경증여중증환인적차이,탐토조기감별중증환인적예경인자.방법 수집2008년3월7일지5월3일재안휘성부양시제일인민의원수치적41례림상진단위수족구병환인적완정자료,기중경증조11례, 뇌염조15례,폐수종조15례,비교3조환인증상、체정、실험실검사、림파세포표형특점급림상전귀정황.결과 폐수종조병사솔위66.7%,교뇌염조현저승고.폐수종조급뇌염조중년령소우3세자체93.3%,여경증조비교차이유통계학의의.폐수종조WBC급중성립세포수교경증조현저승고(P<0.05).폐수종조호흡빈솔、심솔、혈당수평현저고우뇌염조(P<0.05).뇌염조화폐수종조환인T세포、NK세포비례교경증조균현저강저.결론 수족구병환인출현폐수종제시예후불량.년령소우3세환인역출현중증,외주혈WBC급중성립세포증고、호흡증쾌、심솔증쾌、혈당승고가능시병정진전적예측인소.T세포아군적검측유리우수족구병경、중증적감별.
Objective To compare the simple cases of hand-foot-mouth disease(HFMD) with HFMD patients complicated with encephalitis and HFMD cases complicated with pulmonary edema (PE). To explore predictor factors of disease progression and unfavorable prognosis. Methods Forty-one EV71-infected children admitted to the Fuyang First People's Hospital in Anhui Province from March to May in 2008 were investigated in the research, who were classified as encephalitis-complicated cases ( encephalitis group, n = 15 ), PE-complicated cases ( PE group, n = 15 ) and simple cases (simple group, n= 11 ). Their clinical manifestation, laboratory findings, and immunophenotypes of peripheral blood lymphocyte were analyzed to find predictors associated with disease progression and unfavorable outcomes. Results The mortality rate in PE group was 66.7%, which was significantly higher than that in encephalitis group. Ninty-three point three percent cases in PE group and encephalitis group were younger than 3 years old, with statistic difference compared to simple group. Patients in PE group had higher total blood white cell (WBC) counts and higher absolute neutrophil counts and tended to have higher breathing rate, heart i'ate and glucose level than encephalitis group. The percentages of T cells and natural killer (NK) cells were significantly lower among patients complicated with encephalitis than simple HFMD patients.Conclusions PE is one predictor for poor prognosis. Factors correlated with unfavorable outcome include high WBC, high absolute neutrophil counts; elevated breathing rate, heart rate and glucose level. The immunophenotypes of peripheral blood lymphocytes can also predict the disease progression.
