Objective To investigate the clinical and laboratory features of severe cases of hand,foot and mouth disease (HFMD) in Wenzhou, Zhejiang Province. Methods Clinical data of 107 children with HFMD, including 97 severe and 10 critical cases treated in Children' s Hospital Affiliated to Wenzhou Medical College during January and May 2010 were retrospectively analyzed. One hundred and fifty children with mild HFMD were also selected as the controls. Clinical features and laboratory results were compared between the two groups. Results Fever, rash and infection in central nervous system were observed in all patients with severe HFMD, and symptoms on respiratory, digestive and cardiovascular systems were more serious than those of mild HFMD cases. White blood cell counts (WBC) were higher in severe group than those in controls (t = 12.72, P ＜0.01). Hyperglycemia (9. 2 mmol/L) and abnormal troponin (0. 3 -9. 0 ng/mL) were presented in all the critical patients. Cerebrospinal fluid WBC counts were raised in 97 severe HFMD patients (98.5 × 106/L for average) with predominance of lymphocytes. Among 107 severe patients, EV71 was positive in 70, including all 10 critical cases. Conclusion Involvement of nervous,respiratory and digestive symptoms is common in severe cases of HFMD, and EV71 is the predominant pathogen.%目的 分析浙江省温州地区重症手足口病患儿的临床和实验室特征.方法 收集2010年1-5月温州医学院附属儿童医院107例重症手足口病患儿的临床和实验室资料,其中重型97例,危重型10例.随机选取门诊或住院普通手足口病患儿150例作为对照.分析并比较两组患儿的临床特征及实验室检查结果.结果 所有重症患儿均有发热、皮疹和中枢神经系统感染症状,呼吸、消化和心血管系统症状较普通型患儿常见且病情较重.重症患儿外周血白细胞计数明显高于普通组(t=12.72,P＜0.01),且所有危重症患儿均存在高血糖(9.2 mmol/L)和肌钙蛋白异常(0.3～9.0 ng/mL).97例重症患儿脑脊髓液检查WBC升高,平均值为98.5×106/L,以淋巴细胞增高为主.107例重症患儿中,70例(65.4%)患儿EV71阳性,其中10例危重症患儿EV71均为阳性.结论 重症手足口病以EV71感染为主,中枢神经系统、呼吸循环系统及消化系统等多受累,病情严重,临床上应引起重视.
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