儿童手足口病重症病例影响因素的病例对照研究
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国家科技支撑计划(2008BAI70B00)


Case-control study on effect factors of serve Hand-foot-mouth disease among children
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    目的:探讨儿童手足口病(hand-foot-mouth disease,HFMD)重症病例发生的影响因素-方法:采用性别-年龄-入院时间的1∶2匹配的方法对江苏省南京-镇江-扬州-常州市级医疗机构收治的手足口重症病例和轻症病例进行问卷调查,数据分析采用Cox比例风险模型进行单因素和多因素分析-手足口病原学的检测采用PCR方法进行确认-结果:单因素分析显示:发病-入院天数(OR=1.668,95%CI:1.307~2.128)-发热(OR=5.181,95%CI:1.939~13.844)-发热持续天数(OR=1.562,95%CI:1.1421~2.135)-颈项强直(OR=3.188,95%CI:1.055~9.634)-白细胞计数偏高(OR=1.038,95%CI:1.013~1.064)-中性粒细胞计数偏高(OR=1.235,95%CI:1.108~1.378)-Enterovirus 71(EV71)阳性感染(OR=5.069,95%CI:2.472~10.393)是儿童患手足口重症的危险因素,淋巴细胞计数增高(OR=0.968,95%CI:0.944~0.992)-Coxsackievirus A16(CoxA16)阳性(OR=0.191,95%CI:0.094~0.388)患手足口重症的风险比例较小;多因素分析结果显示:发病-入院天数-WBC计数偏高-中性粒细胞计数偏高是儿童患手足口重症的危险因素,其OR值分别为1.668(95%CI:1.122~2.477)-1.304(95%CI:1.080~1.575)-1.088(95%CI:1.001~1.184);CoxA16阳性的儿童患手足口重症的风险比例较小,其OR值为0.169(95%CI:0.038~0.753)-结论:加强对手足口患儿的临床监测和病原学监测,早期诊断,早期治疗,可以有效预防手足口患儿发展成重症的可能性-

    Abstract:

    Objective:To explore the effect factors of serve Hand-foot-mouth disease(HFMD)among children. Methods: A hospital-based case-control study was conducted on two groups of children matched by sex,age and hospital of time. Interview was carried out with uniform designed questionnaires between the case-group with serious complication and control-group with mild symptoms. Cox’s proportional hazards regression analysis was then performed. The pathogen of HFMD was confirmed by RT-PCR. Results: Time intervals between onset date and admission date(OR=1.668,95%CI:1.307-2.128),heating(OR=5.181,95%CI:1.939-13.844)-fever duration(OR=1.562,95%CI:1.142-2.135),stiff neck(OR=3.188,95%CI:1.055-9.634),the higher number of white blood cell(OR=1.038,95%CI:1.013-1.064)and neutrophilic granulocyte(OR=1.235,95%CI:1.108-1.378),and Enterovirus71 infection(OR=5.069,95%CI:2.472-10.393)were risk factors of HFMD among children with serious symptoms,However,lymph-cell counts increase(OR=0.968,95%CI:0.944-0.992),Children infected with CoxA16(OR=0.191,95%CI:0.094-0.388)were the protection factors. The risk factors were found with multivariate analysis,and were associated with time intervals between onset date and admission date(OR=1.668,95%CI:1.122-2.477),the higher number of white blood cell(OR=1.304,95%CI:1.080-1.575)and neutrophilic granulocyte(OR=1.088,95%CI:1.001-1.184),The protections factors was associated with CoxA16 infection(OR=0.169,95%CI:0.038-0.753).Conclusion: To strengthen clinical surveillance and etiology surveillance of HFMD disease,early diagnosis and early treatment can effectively prevent children developing severe hand-foot-and-mouth disease possibility.

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汤奋扬,嵇 红,李 亮,祖荣强,许 可,霍 翔,吴 斌,朱凤才,羊海涛,汪 华.儿童手足口病重症病例影响因素的病例对照研究[J].南京医科大学学报(自然科学版),2011,(1):123-126

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  • 收稿日期:2010-07-02
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