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Severe cases with hand, foot and mouth disease: data based on national pilot hand, foot and mouth disease surveillance system



Severe cases with hand, foot and mouth disease: data based on national pilot hand, foot and mouth disease surveillance system



Zhonghua Liu Xing Bing Xue Za Zhi 38(6): 759-762



目的: 了解手足口病重症病例的患病情况、病原构成以及危险因素。 方法: 对2015年11月1日至2016年11月30日全国手足口病监测试点网络直报系统报告的1 489例手足口病重症及死亡病例进行研究,对基本信息、就诊及治疗情况、临床严重程度及病原构成进行描述性分析并通过多项logistic逐步回归分析重症病例治疗结果的危险因素。 结果: 1 489例重症病例中有7例死亡病例。960例(72.9%)年龄<3岁,937例(62.9%)为男性,病例大部分居住于农村(63.9%)。494例(33.2%)患者首次就诊时选择村级和乡镇级机构。重症病例的发病-就诊、发病-诊断为手足口病和发病-重症诊断的时间间隔分别为0(0~1)d、1(0~2)d和2(1~4)d。并发症有无菌性脑膜炎(51.9%,773例)、非脑干脑炎(25.3%,377例)、脑干脑炎(17.5%,260例)、脑脊髓炎(0.4%,6例)、急性弛缓性麻痹(0.1%,1例)、肺水肿/肺出血(0.3%,4例)和心肺功能衰竭(4.6%,68例)。1 217例纳入病原分析的重症及死亡病例的病原构成依次为肠道病毒(EV)71(52.8%,642例)、其他肠道病毒(21.5%,261例)、柯萨奇病毒(Cox)A16(3.0%,36例)、EV71和Cox A16合并感染(0.1%,1例)。并发症(Z=3.15,P=0.002)和发病-重症诊断的时间(Z=3.95,P<0.001)为治疗结果的危险因素。 结论: 手足口病重症病例以农村男童为主,并发症以无菌性脑膜炎、非脑干脑炎和脑干脑炎为主。EV71是重症及死亡病例的重要病原构成。确诊的及时性以及并发症类型对于治疗结果具有重要影响。.

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Accession: 060241711

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PMID: 28647978


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