目的:探讨EV71病毒感染儿童重症手足口病的临床危险因素.方法:将122例EV71病毒感染的手足口病患儿分为重症组(53例)和轻症组(69例),根据相关因素及临床特征进行单因素分析后再采用Logistic回归分析的方法进行多因素分析.结果:入院时,重症组和轻症组患儿在精神差、心率快、呼吸急促、高热、恶心呕吐、肢体颤抖、血糖和血白细胞等方面进行比较,其差异均有统计学意义(P<0.05).Logistic回归分析显示:精神差、心率快、高热、恶心呕吐及肢体颤抖是重症手足口病的危险因素(P<0.05).结论:手足口病患者出现精神差,病程中伴有高热、恶心呕吐、心率加快和肢体颤抖等症状,需高度警惕为EV71感染的重症手足口病,密切观察患儿病情,及时给予积极有效的治疗,有助于减少手足口病的病死率.%Objective: The primary objectives were to find clinical risk factors of severe hand-foot-mouth disease (HFMD) associated with EV71 infection.Methods: A retrospective clinical case-control study was conducted in 122 hand-foot-mouth disease patients to compare severe and mild cases of patients infected with the EV71 virus.For the significant variables found during univariate analysis, Multi-factorial logistic regression was used to analyze independent associations between potential risk factors and severe HFMD.Results: The results of univariate analysis on the onset of disease showed that risk factors for severe HFMD include reduced consciousness, tachycardia, Tachypnea, fever(>39.1℃), sicchasia and vomiting, myoclonus, hyperglycemia, leukocytosis(P<0.05).The multi-factorial logistic regression revealed that the main risk factors for severe cases were reduced consciousness, tachycardia, fever (>39.1℃)occurring before hospitalization, sicchasia and vomiting,myoclonus(P<0.05).Conclusion: The readily elicited clinical risk factors than were reduced consciousness, tachycardia, fever(>39.1℃) occurring before hospitalization, sicchasia and vomiting,myoclonus were identified to help detect children at severe cases of hand, foot and mouth disease with EV71 virus infection.These risk factors may serve as a guide to clinicians to decide the need for hospitalization and further investigation and close monitoring for disease progression in children with HFMD.
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