摘要
目的：探讨重症手足口病（HFMD）的主要危险因素,为其早期识别、及时治疗提供参考依据。方法：应用Meta分析对1990-2014年国内外关于重症HFMD患者危险因素的病例-对照研究进行综合分析,经异质性检验,分别采用固定效应模型和随机效应模型进行相对危险度（OR）值合并,计算其95%可信区间（95%CI）,并进行敏感性分析及发表偏倚评估。结果：共纳入文献19篇,病例（重症HFMD患者）2 868例,对照（轻症HFMD患者）6 676例。异质性检验,重症HFMD危险因素对应文献异质性检验I2值分别为,年龄≤3岁70%、居住地为农村0%、发病至入院时间≥3d23%、肠道病毒71型（EV71）感染75%、发热≥38.5℃0%、持续发热时间≥3d14%、精神萎靡0%、高血糖（≥6.11mmol·L^-1）51%,各危险因素合并OR及其95%CI分别为2.90（2.14-3.94）、2.21（1.66-2.93）、2.02（1.46-2.79）、2.90（1.24-6.81）、3.13（1.99-4.94）、5.48（3.56-8.45）、4.25（2.45-7.37）和2.87（1.49-5.52）。敏感性分析,固定效应模型和随机效应模型计算结果一致。发表偏倚评估,无明显发表偏倚。结论：农村低龄婴幼儿、就医延迟、EV71感染、持续高热、精神萎靡和血糖水平升高可能是重症HFMD患者发病的主要危险因素。
Objective To investigate the main risk factors of severe hand-foot-mouth disease （HFMD）, and to provide the evidence for the prevention and treatment of HFMD. Methods The case-control studies on the risk factors of patients with severe HFMD from 1994 to 2014 were collected. Meta-analysis was performed to analyze the data. After the heterogeneity test, the fixed and random models were used to calculate the combined odds ratio （OR） and its 95% confidence interval （95% CI）, then the sensitivity analysis was performed and the publish bias was evaluated. Results A total of 19 papers involving Z 868 cases （severe HFMD patients ） and 6 676 controls （mild HFMD patients） were included in the review. The heterogeneity test results about/2 was showed as follows： age ≤3 years was 70%, rural residence was 0%, duration onset to admission ≥3 d was 23%, enterovirus 71 （EV71） infection was 75%, degree of fever ≥38.5℃ was 0%, duration of fever ≥3 d was 14%, withdrawnness and lethargy was 0%, and hyperglycaemia （≥6.11 mmol · L^-1） was 51%. The pooled OR and 95%CIof the risk factors of severe HFMD were 2.90 （2.14-3.3.94）, 2.21 （1.66-2.93）, 2.02 （1.46- 2.79）, 2.90 （1.24-6.81）, 3.13 （1.99-4.94）, 5.48 （3.56-8.45）, 4.25 （2.45-7.37）, and 2.87 （1.49- 5.52）. The sensitivity analysis showed that the results calculated by the fixed and random models were consistent. The publish bias evaluating results showed that there was no obvious publish bias. Oonclusion The rural younger children, diagnosis and treatment delay, EV71 infection, high fever duration, withdrawnness and lethargy, and hyperglycemia might be the risk factors of the patients with severe HFMD.
出处
《吉林大学学报（医学版）》
CAS
CSCD
北大核心
2015年第5期974-979,共6页
Journal of Jilin University：Medicine Edition
基金
国家自然科学基金资助课题(81473030)
河南省郑州市科技局技术研究与开发经费资助课题(141PPTGG440)
