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目的研究杭州市重症手足口病(HFMD)流行特征,比较不同肠道病毒感染后的差异,寻求早期预判重症HFMD关键指标。方法对2014年杭州市儿童医院收治的498例重症HFMD患儿进行统计分析。采集重症患儿的脑脊液进行常规检测,并比较不同病原体感染后临床症状的差别。结果 498例重症HFMD患儿中,男女患儿比例为1.6∶1,1岁~3岁患儿占76.7%。重症组患儿平均年龄为(2.6±1.2)岁,重症HFMD患儿以EV71感染为主,占76.5%(381/498)。EV71感染的患儿肢体抖动和呕吐的发生率高于其他肠道病毒感染(P<0.05)。EV71感染脑脊液有核细胞计数和蛋白质定量明显高于其他肠道病毒感染(P<0.05)。结论年龄小、EV71感染、脑脊液有核细胞计数和蛋白质含量增高,出现肢体抖动和呕吐等临床症状,是预判重症发展为危重症HFMD的重要因素。
Objective To study the epidemiological characteristics of HFMD in Hangzhou and to compare the differences after different enterovirus infections and to seek the key indicators for early diagnosis of severe HFMD. Methods 498 children with severe HFMD admitted to Hangzhou Children’s Hospital in 2014 were analyzed statistically. Cerebrospinal fluid was collected from critically ill children for routine testing and compared with clinical symptoms after infection with different pathogens. Results Among 498 cases of severe HFMD, the male-female ratio was 1.6:1, and the rate of children aged 1 to 3 was 76.7%. The average age of children in severe group was (2.6 ± 1.2) years old. The majority of children with severe HFMD were infected with EV71, accounting for 76.5% (381/498). The incidence of limb jitter and vomiting in EV71 infected children was higher than that of other enterovirus infections (P <0.05). Cerebrospinal fluid nucleated cell count and protein quantitation in EV71 were significantly higher than those in other enteroviruses (P <0.05). CONCLUSIONS: Small age, EV71 infection, cerebrospinal fluid nucleated cell count and protein content increased, and clinical symptoms such as limb jitter and vomiting appeared. It is an important factor in predicting the severe development of HFMD in critically ill patients.