疱疹性咽峡炎发展为手足口病患儿早期临床表现分析

目的 观察疱疹性咽峡炎患儿的早期临床症状和体征,以便早期识别有可能发展为手足口病的疱疹性咽峡炎患儿.方法 选取我院2012-2013年儿科病区临床早期诊断为疱疹性咽峡炎患儿80例,随病情进展分为3组.A组为单纯疱疹性咽峡炎组患儿42例；B组为疱疹性咽峡炎发展为手足口病组患儿28例,C组为发展为重症手足口病患儿10例.分别检测3组患儿血常规及淋巴细胞计数、中性粒细胞计数,并监测其发热程度、血压、心率、呼吸及消化系统、神经系统症状.结果 A、B、C组患儿白细胞计数、淋巴细胞计数、中性粒细胞计数比较差异均无统计学意义（P均＞0.05）；患儿发热程度、热程、心率、呼吸频率、收缩压、舒张压比较差异均有统计学意义（F值分别为5.03、3.62、4.83、3.65、6.72、3.74,P均＜0.05）；同时伴有明显食欲减退、呕吐、腹泻消化道症状和易惊、肢体抖动、嗜睡神经系统症状,差异均有统计学意义（x2值分别为6.10、5.75、4.86、3.58、3.42、4.35,P均＜0.05）.结论 疱疹性咽峡炎患儿如热度高、热程长,心率、呼吸偏快、血压偏高,伴有食欲减退、呕吐或腹泻和/或伴有易惊或肢体抖动、嗜睡症状,进一步发展为手足口病的可能性大.

Clinical analysis of symptoms and signs of herpangina children developing into hand-foot-mouse disease

Objective To analyze the relationships and differences of the clin（HFMD） ical signs and the possibility of children with herpangina developing into HFMD by observing the clinical signs.Methods Eighty children diagnosed herpangina clinically firstly were divided into Group A,B and C.Group A included 42 cases with only herpangina,and Group B including 28 cases who were herpangina developing into mild HFMD and Group C including 10 cases with serve HFMD.The clinical signs of the three groups,including blood routine test and lymphocyte count,neutrophil count,and monitor the degree of fever,blood pressure,heart rate,respiratory and digestive system,nervous system symptoms were recorded.Results In Group A,B and C,white blood cell number,lymphocyte number,neutrophil number were no significant difference（P ＞ 0.05）.However,fever degree,thermal history,heart rate,respiratory rate,systolic pressure,diastolic pressure were significant differences （F =5.03,3.62,4.83,3.65,6.72,3.74 ; P ＜ 0.05）.Meanwhile The sigh of loss of appetite,vomiting,diarrhea,gastrointestinal symptoms and easily frightened,limb jitter,sleepiness were statistically significant（x2 =6.10,5.75,4.86,3.58,3.42,4.35;P ＜0.05）.Conclusion The herpangina children with symptoms and signs such as higher fever and higher blood pressure,simultaneously with diarrhea,vomiting,hyperarousal and amyostasia,have the more chance to develop HFMD.