重症手足口病患儿危险因素分析

目的 观察重症手足口病(HFMD)患儿的主要实验室检测结果,寻找重症HFMD的危险因素并建立预测模型,为早期诊断、及时治疗提供帮助.方法 选取2019年1-12月蚌埠医学院第一附属医院收治的HFMD患儿(包括临床诊断病例和确诊病例)为研究对象,分析临床症状、体征及主要的实验室指标,差异有统计学意义项进行多因素logis...

Analysis of risk factors of children with severe hand-foot-mouth disease

Objective To observe the primary laboratory examination results of children with severe hand-foot-mouth disease(HFMD),determine their risk factors and establish a prediction model to provide early diagnosis and timely HFMD treatment.Methods Children with HFMD(including clinical diagnosis cases and confirmed cases)were included in the study.They were admitted to the First Affiliated Hospital of Bengbu Medical College from January 2019 to December 2019.The clinical symptoms,signs and major laboratory indicators were analysed,and statistically significant terms were further processed via multifactor logistic regression to build a regression model.ROC curves were drawn to evaluate the predictive effect of the model.Data were analysed using SPSS 26.0 software.Results The clinical data of 109 HFMD cases(including 41 mild cases and 68 severe cases),showed that body temperature of≥38.9℃(OR=2.943,95%CI:1.099-7.884),poor spirit(OR=5.899,95%CI:2.130-16.339),increased peripheral blood white blood cells(OR=4.386,95%CI:1.420-13.541)and abnormal electroencephalogram(OR=4.502,95%CI:1.714-11.821)were independent risk factors for severe HFMD.The regression equation of the prediction model was Logit(P)=-2.893+1.079 X₁+1.775 X₂+1.478 X₃+1.504 X₄.The sensitivity of the model was 61.0%,and its specificity was 83.8%.The area under the curve corresponding to the ROC curve was 0.843(95%CI:0.768-0.917).Conclusion Body temperature of≥38.9℃,poor spirit,increased peripheral blood white blood cells and abnormal electroencephalogram are independent risk factors for severe HFMD.These risk factors can be used to establish a predictive logistic regression model for severe HFMD.