摘要
目的探讨手足口病（HFMD）重症化的危险因素及病理改变，为临床干预提供依据。方法回顾性分析宁波市第二医院2010年1月至2012年12月住院的2606例HFMD患儿的临床资料，分为普通组和重症组，分析筛选出HFMD重症化的危险因素；并对1例死亡患儿实施尸体解剖，分析其病理改变。结果2606例患儿中，重症HFMD619例（23．7％）；多因素分析显示EV71感染、精神差、血糖〉9mmol／L、高热（体温≥39．1℃）持续3d以上、年龄〈3岁以及神经反射异常等6项指标是HFMD重症化的独立相关因素；重症患儿的病变主要在中枢神经系统、肺脏以及肠道。结论对于EV71感染、年龄〈3岁且伴有精神、神经系统症状和血糖升高的高热HFMD患儿需关注其病情变化，并进行针对性的临床干预，且肠道功能的保护不容忽视。
Objective To explore the risk factors and clinicopathologic characteristics of severe hand, foot and mouth disease （HFMD） , and to provide a scientific basis for clinical interventions. Methods The clinical data of 2606 hospitalized children with HFMD in Ningbo No. 2 Hospital were analyzed retrospectively from January 2010 to December 2012. Clinical characteristics were compared between two groups （ regular case group and severe case group） , and risk factors of severe HFMD were analyzed by Logistic regression test. The clinicopathologic features were analyzed from an autopsy case. Results Among total 2606 cases, 619 cases were severe HFMD （23.7%）. Logistic regression test showed that EV71 infection, poor spirit, blood glucose 〉 9 mmol/L, high fever （temperature ≥ 39.1 ℃ ） lasted more than three days, younger than 3 years and abnormal neural reflex were the independent risk factors of HFMD seriousness. The results of the autopsy showed that the central nervous system, lung and intestinal were most severely. Conclusion Attention should be paid to observe the condition changes in HFMD patients with EV71 infection, younger than 3 years, nervous system symptoms, blood glucose 〉 9 mmol/L and high fever. Targeted clinical intervention is particularly important for improving cure rate, and the protection of intestinal function can＇t be ignored.
出处
《中华实验和临床病毒学杂志》
CAS
CSCD
2013年第6期420-422,共3页
Chinese Journal of Experimental and Clinical Virology
基金
宁波市医学科技计划项目（2013A15）
浙江省医坛新秀培养对象项目（2013-245）
宁波市优秀中青年卫生技术人才项目（2011-145）
宁波市领军和拔尖人才项目（2012-131）
关键词
手足口病
危险因素
病理学
临床医学
Hand, foot and mouth disease
Risk factors
Pathology
Clinical medicine
