中华传染病杂志
中華傳染病雜誌
중화전염병잡지
CHINESE JOURNAL OF INFECTIOUS DISEASES
2014年
3期
154-157
,共4页
杨朝晖%秦承志%季金萍%王成宝
楊朝暉%秦承誌%季金萍%王成寶
양조휘%진승지%계금평%왕성보
手足口病%发热%神经病学表现%白细胞增多%中性白细胞%病例对照研究
手足口病%髮熱%神經病學錶現%白細胞增多%中性白細胞%病例對照研究
수족구병%발열%신경병학표현%백세포증다%중성백세포%병례대조연구
Hand,foot and mouth disease%Fever%Neurologic manifestations%Leukocytosis%Neutrophils%Case-control studies
目的 研究儿童手足口病发生重症的危险因素.方法 采用回顾性研究方法,调查2011年山东省临沂市人民医院感染科1 570例住院患儿临床资料,数据分析采用单因素、多因素Logistic回归分析.结果 重症组(包括重症和危重症)患儿年龄为(25.0±14.0)个月,以1～5岁居多;轻症组为(27.1±15.8)个月(t’=-2.717,P=0.007).两组男童分别占61.0％和65.9％(x2=3.894,P=0.048).重症组伴有发热、惊厥、肢体抖动、呕吐等表现者多于轻症组,中性粒细胞、CK明显高于轻症组.单因素Logistic回归分析显示,年龄(OR=1.799,95％CI:0.984～1.997)、女童(OR=1.234,95％CI:1.001～1.522)、高热(OR=2.110,95％CI:1.816～2.452)、惊厥(OR=1.878,95％CI:1.578～2.236)、恶心呕吐(OR=1.760,95％CI:1.456～2.128)、中性粒细胞增高(OR=1.031,95％CI:1.025～1.037)、CK增高(OR=1.002,95％CI:1.001～1.003)是儿童重症手足口病发生的危险因素.多因素Logistic回归分析显示,高热(OR=1.751,95％CI:1.487～2.062)、惊厥(OR=1.451,95％CI:1.204～1.749)、恶心呕吐(OR=1.269,95％CI:1.027～1.568)、中性粒细胞增高(OR=1.028,95％CI:1.021～1.035)是重症手足口病的危险因素.结论 密切关注手足口病患儿的体温、神经系统表现和中性粒细胞改变,可有效降低其发展为重症的可能性.
目的 研究兒童手足口病髮生重癥的危險因素.方法 採用迴顧性研究方法,調查2011年山東省臨沂市人民醫院感染科1 570例住院患兒臨床資料,數據分析採用單因素、多因素Logistic迴歸分析.結果 重癥組(包括重癥和危重癥)患兒年齡為(25.0±14.0)箇月,以1～5歲居多;輕癥組為(27.1±15.8)箇月(t’=-2.717,P=0.007).兩組男童分彆佔61.0％和65.9％(x2=3.894,P=0.048).重癥組伴有髮熱、驚厥、肢體抖動、嘔吐等錶現者多于輕癥組,中性粒細胞、CK明顯高于輕癥組.單因素Logistic迴歸分析顯示,年齡(OR=1.799,95％CI:0.984～1.997)、女童(OR=1.234,95％CI:1.001～1.522)、高熱(OR=2.110,95％CI:1.816～2.452)、驚厥(OR=1.878,95％CI:1.578～2.236)、噁心嘔吐(OR=1.760,95％CI:1.456～2.128)、中性粒細胞增高(OR=1.031,95％CI:1.025～1.037)、CK增高(OR=1.002,95％CI:1.001～1.003)是兒童重癥手足口病髮生的危險因素.多因素Logistic迴歸分析顯示,高熱(OR=1.751,95％CI:1.487～2.062)、驚厥(OR=1.451,95％CI:1.204～1.749)、噁心嘔吐(OR=1.269,95％CI:1.027～1.568)、中性粒細胞增高(OR=1.028,95％CI:1.021～1.035)是重癥手足口病的危險因素.結論 密切關註手足口病患兒的體溫、神經繫統錶現和中性粒細胞改變,可有效降低其髮展為重癥的可能性.
목적 연구인동수족구병발생중증적위험인소.방법 채용회고성연구방법,조사2011년산동성림기시인민의원감염과1 570례주원환인림상자료,수거분석채용단인소、다인소Logistic회귀분석.결과 중증조(포괄중증화위중증)환인년령위(25.0±14.0)개월,이1～5세거다;경증조위(27.1±15.8)개월(t’=-2.717,P=0.007).량조남동분별점61.0％화65.9％(x2=3.894,P=0.048).중증조반유발열、량궐、지체두동、구토등표현자다우경증조,중성립세포、CK명현고우경증조.단인소Logistic회귀분석현시,년령(OR=1.799,95％CI:0.984～1.997)、녀동(OR=1.234,95％CI:1.001～1.522)、고열(OR=2.110,95％CI:1.816～2.452)、량궐(OR=1.878,95％CI:1.578～2.236)、악심구토(OR=1.760,95％CI:1.456～2.128)、중성립세포증고(OR=1.031,95％CI:1.025～1.037)、CK증고(OR=1.002,95％CI:1.001～1.003)시인동중증수족구병발생적위험인소.다인소Logistic회귀분석현시,고열(OR=1.751,95％CI:1.487～2.062)、량궐(OR=1.451,95％CI:1.204～1.749)、악심구토(OR=1.269,95％CI:1.027～1.568)、중성립세포증고(OR=1.028,95％CI:1.021～1.035)시중증수족구병적위험인소.결론 밀절관주수족구병환인적체온、신경계통표현화중성립세포개변,가유효강저기발전위중증적가능성.
Objective To study the risk factors of severe hand-foot-mouth disease (HFMD) among children.Methods The clinical data of 1 570 children with HFMD at Linyi People's Hospital in Shandong Province in 2011 were collected,retrospectively.The data were analyzed using univariate and multivariate Logistic regression.Results The mean age of severe HFMD (including severe and critical HFMD) was (25.0± 14.0) months old,predominantely aged between 1 and 5 years old,while mild HFMD was (27.1±15.8) months (t'=-2.717,P=0.007).There were 61.0％ and 65.9％ boys in two groups,respectively (x2 =3.894,P=0.048).Fever,convulsion,tremor,nausea and vomiting were more frequently seen in severe HFMD.The neutrophil count and the level of creatine kinase in severe HFMD were both significantly higher than that in mild HFMD.Univariate analysis revealed that age (odds ratio [OR]=1.799,95％CI:0.984-1.997),girl sex (OR=1.234,95％CI:1.001-1.522),high fever (OR=2.110,95％CI:1.816-2.452),convulsion (OR=1.878,95％CI:1.578-2.236),nausea and vomiting (OR=1.760,95％CI:1.456-2.128),neutrophil count (OR=1.031,95％CI:1.025-1.037) and creatine kinase (OR=1.002,95％CI:1.001-1.003) were risk factors for severe HFMD.Multivariate Logistic regression showed that high fever (OR =1.751,95％ CI:1.487-2.062),convulsion (OR=1.451,95％CI:1.204-1.749),nausea and vomiting (OR=1.269,95％CI:1.027-1.568),neutrophil count (OR=1.028,95％CI:1.021-1.035) were independent risk factors.Conclusions Body temperature,neurological manifestations and trend of neutrophil counts should be carefully monitored in children with HFMD.Prevention of the development of severe HFMD mainly relies on the identification of risk factors and adoption of precautions in time.
