烟台地区手足口病931例流行病学及临床特征分析

目的了解烟台地区手足口病住院病例的流行病学及临床特征。方法回顾性分析我院2009--2010年住院的手足口病患儿的流行病学及临床资料。结果931例中,5岁以下儿童881例,占94．6％,男女之比为1．5：1;全部患儿（100．0％）均有皮疹,840例（90．2％）患儿发热,神经系统受累者121（13,0％）例。病例集中就诊于4—9月份,共计828例,占88．9％;月病例数与月平均气温呈正相关（r=0．887,P〈0．001）。单因素分析显示,22（2．4％）例重症病例中农村儿童比例、发热持续时间、血清CRP水平和空腹血糖水平均显著高于普通病例;多因素分析发现,只有发热持续时间和空腹血糖水平是重症病例的独立预测因素,其比值比OR（95％CI）分别为1．491（1．170—1．901）和1．124（1．016～1．245）,P值分别为0．001和0．024。结论本地区手足口病好发于5岁以下儿童,发病高峰为4～9月份,与本地区月平均气温正相关;发热持续时间和空腹血糖水平是重症病例的独立预测因素。多数患儿只要早诊断、早治疗,预后一般良好。

Epidemiological study and clinical analysis of 931 children with hand foot and mouth disease in Yantai

Objective To discuss the epidemiological and clinical characteristics of the hospitalized children with hand foot and mouth disease （HFMD） in Yantai area. Methods Epidemiological and clinical data of HFMD children from 2009 to 2010 were summarized and analyzed retrospectively. Results Most of the infected（94.6% ） were under 5 years old and the ratio between male and female was 1.5 ： 1. Oral mucosal pox or ulcer as well as hand and foot rashes were observed in all 931 patients. Fever and neurological disorders occurred in 840（90.2% ）and 121 （13.0%） patients respectively. The incidence was positively correlated with air temperature （ r = 0. 887, P 〈 0. 001 ）, with a peak in April to September （88.9%）. The ratio of children from countryside, total duration of fever, serum concentration of c-reacting protein （CRP） and fasting blood glucose（FBG） were significantly higher in severe cases than in those mild ones. Multivariate analysis showed longer mean duration of fever（ Odds ratio OR] , 1. 491 ;95% confidence interval CI] 1. 170-1. 901 ;P = 0. 001 ） and hyperglycemia（ OR, 1. 124 ; 95 % CI 1. 016-1. 245 ; P = 0. 024 ） were independent risk factors of severity. Conclusion Children younger than 5 years old are susceptible to HFMD and most cases occur in April to September. The monthly incidence is positively correlated with temperature of that month. Longer duration of fever and hyperglycemia are independent risk factors for severity. Most cases could have a favorable prognosis after timely diagnosis and proper intervention.