北京市2010年手足口病死亡危险因素分析

目的探讨北京市手足口病死亡的危险因素,为防制手足口病、减少手足口病死亡提供科学依据。方法收集2010年北京市手足口病重症和死亡病例资料,采用多因素Logistic回归分析对手足口病死亡的危险因素进行分析。结果 2010年北京市报告重症手足口病610例,其中死亡病例18例,重症病例病死率为2.95%。结果显示:患者年龄、户口类型为流动人口、诊断重症病例的医院类型为县医院、到村级(个体)医疗机构就诊和病原检测结果为肠道病毒71型(enterovirus 71,EV71)是重症手足口病死亡的影响因素。结论为减少手足口病死亡病例的发生,应重视1岁以下婴幼儿,流动人口和EV71感染儿童的防控工作,手足口病患者应到正规医院就诊,发现重症早期症状者应立即转诊到具有诊治重症病例能力的医疗机构进行科学规范救治。

Characteristics of etiology and epidemiology of hand,foot and mouth disease in Jinan City,2010

Objective To study the characteristics on etiology and epidemiology of hand,foot and mouth disease(HFMD) in Jinan,2010,and provide scientific basis for prevention and control of this disease.Methods Specimens including stool and pharynx swabs were collected from 808 clinically-diagnosed cases of HFMD(including 40 severe cases) in Jinan,2010,and the RT-PCR analysis was used with universal primers within 5’untranslated region of enterovirus and VP1 region of coxsackievirus A16(CoxA16) and enterovirus 71(EV71) to assay enteroviruses in children with HFMD.The VP1 genes of EV71 from EV71 positive cases were amplified by RT-PCR and sequences were analyzed.Results The positive rate of enterovirus was 71.91%(581/808).Of the 581 cases,190(32.70%) were positive for EV71,267(45.96%) were positive for CoxA16,and 124(21.34%) were negative for both EV71 and CoxA16.The major pathogen of 40 severe HFMD were EV71(75.00%).In positive cases,the majority was male;the age of most cases was less than 4 years old(85.15%),especially in 2-3 years old group(28.34%);and the high-occurrence season of HFMD was from April to May(36.14%)in Jinan,2010.Gene sequence analysis for 7 strains of EV71 PCR positive products presented as the same C4b.Conclusions The major pathogens of HFMD cases are EV71 and CoxA16 in Jinan.Children less than 4 years old are susceptible to HFMD,and severe cases of HFMD were mainly caused by EV71.