摘要
目的分析2011—2012年枣阳市手足口病的临床特征。方法收集2011年3月～2012年8月枣阳市一医院手足口病病区收治的手足口病患儿的病例资料，比较普通型，重症型临床表现和辅助检查的异同。结果①手足口病患儿的呼吸、心率、血压的改变在普通型组和重症型组不明显。与重型组比较，普通型组低热（38．0℃以内）例数相对较多，2组差异有统计学意义（P〈0．05）。中度发热（38．1℃39．0℃）及高热（39．1～41．0℃）差异无统计学意义（P〉0．05）；超高热在两组中均未发现。普通型组和重症型组血糖升高（6．5mmol／L）病例数比较，差异无统计学意义（P〉0．05）；重症型组血糖升高8．3mmol／L以上与8．3mmol／L以下病人的预后比较，差异有统计学意义（P〈0．05）。②实验室检查的特点，普通型组与重症型组均无肌钙蛋白的升高；外周血白细胞计数升高（10×10^9／L）例数比较，差异无统计学意义（P〉0．05）；两组手足口病毒EV71-Ab阳性比较，差异有统计学意义（P〈0．05）；重症型脑脊液白细胞升高率87．86％。③重症型早期胸片有支气管肺炎和无支气管肺炎发展为危重型例数比较，差异有统计学意义（P〈0．05）。结论神经系统受累是临床早期识别该病重症的重要临床特点，脑脊液白细胞改变突出，血糖升高8．3mmol／L以上，胸片有支气管肺炎改变的重症型有可能进展为重症危重型。
Objective To analysis the clinical features of hand -foot- mouth disease （HFMD）in Zaoyang. Methods Clinical features of hospitalized children with HFMD in the First Hospital of Zaoyang from Mar. 2011 to Aug. 2012 were analyzed retrospectively. Clinical features as well as results of auxiliary examination between common HFMD group and severe HFMD group were compared. Results （ 1 ） No significant difference was observed in breath, heart rate or blood pressure in both groups. There were more cases with low fever（ below 38.0℃ ）in common HFMD group（P 〈 0. 05 ）. There was no significant difference in number of cases with moderate fever（ 38.1 - 39.0℃ ） and high fever（39.1 -41.0℃ ）between two groups（ P 〉 0. 05 ）. No case with temperature more than 41.0℃ in either group. There was no significant difference in cases with raised blood glucose（6.5 mmol/L）between two groups（ P 〉 0.05）. There was significant difference in prognosis in two subgroups in intensive HFMD group：blood glucose level increased above 8.3 mmoL/L and below 8.3 mmol./L （ P 〈 0.05 ）. （ 2 ） Cardiac troponin was not elevated in both groups. There was no significant difference in raised peripheral white blood count （ 10×10^9/L） （ P 〉 0.05 ）. There was significant difference in EV71 - IgM （ ＋ ） （ P 〈 0.05 ）. The CSF - WBC raised by 87.86% in severe HFMD group. （3）There was significant difference in cases developing to critical type with bronchopneumonia and without bronchopneumonia by chest radiograph in severe HFMD group （ P 〈 0.05 ）. Conclusion Heavy burdens of central nervous system and corresponding symptoms were signals of severe HFMD. Severe HFMD with drastic change in CSF - WBC, raised blood glucose level by more than 8.3 mmol/L and chest radiograph with bronchopneumonia might de- velop to severe critical type.
出处
《医学新知》
CAS
2013年第1期31-36,共6页
New Medicine
关键词
肠道病毒EV71型
手足口病
临床特征
重症型
Enterovirus 71
Hand - foot - mouth disease
Clinical features
Intensive group
