CAJ | 학술논문

目的探讨重症手足口病并发神经源性肺水肿的危险因素.方法根据有无并发神经源性肺水肿将79例重症于足口病患儿分为两组,分析两组在临床症状、体征、实验窒检查及脑电图检查结果之间的差异,Logistic回归分析并发神经源性肺水肿的危险因素.结果两组患儿在肠道病毒71型的感染率,高体温、肌阵挛、肢体麻痹、眼球调节障碍、心动过速、血压升高或降低、毛细血管再充盈时间延长的发生率,以及白细胞计数、肌酸激酶同工酶、血糖升高的发生率方面差异均有显著性(P＜0.05),而发热、热程、呕吐、嗜睡、抽搐、抖动、C反应蛋白、脑电图结果两组间比较差异无显著性(P＞0.05).多因素Logistic回归分析发现,心动过速、血压升高或降低、血糖升高是神经源性肺水肿发生的危险因素,而且血糖升高具有最大相对危险度(OR=27.075,P=0.000 2).结论心动过速、血压升高或降低、血糖升高是神经源性肺水肿发生的危险因素,尤其血糖升高对预测神经源性肺水肿的发生有重要意义.
목적 탐토중증수족구병병발신경원성폐수종적위험인소.방법 근거유무병발신경원성폐수종장79례중증우족구병환인분위량조,분석량조재림상증상、체정、실험질검사급뇌전도검사결과지간적차이,Logistic회귀분석병발신경원성폐수종적위험인소.결과 량조환인재장도병독71형적감염솔,고체온、기진련、지체마비、안구조절장애、심동과속、혈압승고혹강저、모세혈관재충영시간연장적발생솔,이급백세포계수、기산격매동공매、혈당승고적발생솔방면차이균유현저성(P＜0.05),이발열、열정、구토、기수、추휵、두동、C반응단백、뇌전도결과량조간비교차이무현저성(P＞0.05).다인소Logistic회귀분석발현,심동과속、혈압승고혹강저、혈당승고시신경원성폐수종발생적위험인소,이차혈당승고구유최대상대위험도(OR=27.075,P=0.000 2).결론 심동과속、혈압승고혹강저、혈당승고시신경원성폐수종발생적위험인소,우기혈당승고대예측신경원성폐수종적발생유중요의의.
Objective To understand the risk factors of neurogenic pulmonary edema in the patients with severe hand foot and mouth disease(HFMD). Methods According to neurogenic pulmonary edema or not ,79 patients with severe HFMD were divided into two groups. The difference was analyzed on the clinical symptoms, signs,the outcomes of laboratory and electroencephalogram (EEG) examination between the two groups. Then the risk factors of neurogenic pulmonary edema was analyzed by logistic regression analysis.Results There were significant differences of the EV71 infection rate,high body temperature,myoclonia,limb weakness,the disability of eyeball regulation,tachycardia, hypertension or hypotension, the extension of capillary filling time, leucocytosist, creatine kinase isoenzyme, hyperglycaemia between two groups. However, there were no significant differences of fever, fever time, vomiting, somnolence, convulsion, limb tremor, c-reactive protein and EEG between two groups. Tachycardia, hypertension or hypotension, hyperglycaemia were significant risk factors for neurogenic pulmonary edema by logistic regression analysis. And hyperglycaemia was the most significant prognostic factor(odd ratio 27. 075, P = 0. 000 2). Conclusion Tachycardia, hypertension or hypotension,hyperglycaemia are the significant risk factors for neurogenic pulmonary edema. It is especially important for hyperglycaemia to predict neurogenic pulmonary edema.