重症手足口病并发神经源性肺水肿高危因素研究

目的探讨重症手足口病并发神经源性肺水肿的高危因素。方法根据有无并发神经源性肺水肿将56例重症手足口病患儿分为两组,分析两组在临床症状、体征、实验室检查结果之间的差异,Logistic回归分析并发神经源性肺水肿的高危因素。结果两组在肠道病毒71型(EV71)感染、高热、呼吸急促、心动过速、血压升高、白细胞计数升高、高血糖方面差异均有统计学意义(P<0.05);两组发热持续时间≥3 d、呕吐、嗜睡、易惊、腱反射亢进、C反应蛋白升高发生率比较差异均无统计学意义(P>0.05)。多因素Logistic回归分析显示:高血糖、心动过速、血压升高、呼吸急促、白细胞计数升高是神经源性肺水肿发生的危险因素,而且高血糖具有最大相对危险度(OR=225.000,P=0.000)。结论高血糖、心动过速、血压升高、呼吸急促、白细胞计数升高是神经源性肺水肿发生的高危因素,尤其是高血糖对预测神经源性肺水肿的发生有重要意义。

Clinical Risk Factors of Neurogenic Pulmonary Edema in Patients with Severe Hand,Foot and Mouth Disease

Objective To investigate risk factors of neurogenic pulmonary edema(NPE)in patients with severe hand,foot and mouth disease(HFMD).Methods According to whether there was NPE or not,56 patients with severe HFMD were divided into two groups.The difference of clinical symptoms,vital signs and the outcomes of laboratory examinations between the two groups were analyzed and the risk factors of NPE were analyzed by logistic regression analysis.Results The differences of EV71 infection rate,hyperthermia,tachypnea,tachycardia,hypertension,leukocytosis and hyperglycemia between two groups were statistically significant(P<0.05).While the differences of fever duration≥3 d,vomiting,somnolence,tremor,tendon reflex enhancement and elevated C-reactive protein between the two groups were not statistically significant(P>0.05).Logistic regression analysis showed that hyperglycemia,tachycardia,hypertension,tachypnea and leukocytosis were risk factors of NPE,and hyperglycemia was the most significant prognostic factor(OR=225.000,P=0.000).Conclusion Hyperglycemia,tachycardia,hypertension,tachypnea and leukocytosis were risk factors of NPE,and hyperglycemia is of great importance in predicting NPE.