深圳市危重型手足口病危险因素分析

目的 与重型手足口病对比,探讨深圳市危重型手足口病的危险因素. 方法 以2012年1—8月深圳市儿童医院诊治的38例危重型手足口病例作为危重型组,以同期该院的75例重型手足口病例为作为重型组,使用单因素和多因素非条件Logistic回归分析影响因素. 结果 居住在非住宅小区、未参加医疗保险、自然分娩、发病至诊断重症间隔2d以上、曾去个体（民营）医院就诊和曾去社康中心就诊等为危重型手足口病的危险因素[OR（95 ％CI）分别为8.40（2.95～23.89）;10.72（2.40 ～48.00）,3.40（1.24～9.33）,3.48（1.47～8.27）,3.57（1.16 ～10.94）和4.50（1.06～19.13）];多因素Logistic回归分析显示居住在非住宅小区、未参加医疗保险为其危险因素.危重型组、重型组EV71检出率分别为87.9％,33.3％,差异有统计学意义. 结论 为减少危重型手足口病的发生,对社会经济状况相对较差家庭的儿童和EV71感染者应给予密切关注.

Analysis on the risk factors of critical cases with hand-foot-mouth disease in Shenzhen City

Objective To explore the risk factors of critical cases of Hand-foot-mouth disease （HFMD） by comparing with severe cases.Methods Thirty-eight critical HFMD cases and 75 severe cases from Shenzhen were selected from Shenzhen Children＇s Hospital between January and August 2012.All cases were diagnosed according “Diagnosis and Treatment Guideline on Hand-foot-mouth disease （2010）”,established by Ministry of Health,the People＇s Republic of China.Questionnaire survey and intestinal virus nucleic acid detection were carried out.Logistic regression and Chi square test were used in data analysis.Results The results of univariate analysis showed that living in no-residence community,having no health insurance,spontaneous birth,longer duration （＞ 2 days） between incidence and have a diagnosis of severe case,once treated in private clinics and community health center were risk factors of critical HFMD,with an OR （95 ％ CI） of 8.40 （2.95-23.89）,10.72 （2.40-48.00）,3.40 （1.24-9.33）,3.48 （1.47-8.27）,3.57 （1.16-10.94） and 4.50 （1.06-19.13）,respectively.Based on multivariate non-conditional logistic regression analysis,risk factors associated with critical HFMD included living in no-residence community,and having no health insurance.The EV71 positive rate of critical HFMD was 87.9％ （29/33）,which was significantly higher than severe HFMD （33.3％,8/24）.Conclusion To reduce the incidence of critical HFMD,more attention should be paid to children of families with low social-economic status and children infected by EV71 virus.