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目的探讨重症手足口病(HFMD)重型进展为危重型的早期临床特征及危险因素。方法危重型HFMD 66例(观察组),同期住院重型HFMD 132例(对照组),采用单因素及多因素非条件Logistic回归分析比较两组临床表现、辅助检查的差异,探讨重型HFMD进展为危重型的危险因素。结果单因素分析提示年龄≤3岁、精神差、嗜睡、频繁惊跳或抖动、呕吐(>3次/d)、循环不良、白细胞升高(>15×109/L)、血糖高、肺部渗出性改变为主要危险因素,其相对危险度(OR)值分别为5.617、1.842、1.072、7.916、6.743、10.385、4.952、3.127、2.864。多因素非条件Logistic回归分析表明年龄≤3岁、频繁惊跳或抖动、呕吐(>3次/d)、循环不良、白细胞升高(>15×109/L)为重型手足口病进展为危重型的独立危险因素。结论年龄≤3岁、频繁惊跳或抖动、呕吐(>3次/d)、循环不良、白细胞升高(>15×109/L)与重型手足口病进展为危重型高度相关。
Objective To investigate the early clinical features and risk factors of critically ill hand-foot-mouth disease (HFMD). Methods Sixty-six patients with HFMD were divided into two groups: control group (n = 66) and control group (n = 132). One-factor and multivariate non-conditional Logistic regression analysis was used to compare the differences of clinical manifestations and auxiliary examinations between two groups Type of risk factors. Results Univariate analysis showed that the patients were ≤3 years old with poor psychosis, drowsiness, frequent jitter or jitter, vomiting (> 3 times per day), poor circulation, elevated white blood cells (> 15 × 109 / L) Exudative changes as the main risk factors, the relative risk (OR) values were 5.617,1.842,1.072,7.916,6.743,10.385,4.952,3.127,2.864. Multivariate non-conditional logistic regression analysis showed that the onset of severe hand-foot-and-mouth disease was critically severe when age ≤3 years, frequent beatings or jitter, vomiting (> 3 times per day), poor circulation and leukocytosis (> 15 × 109 / L) Type of independent risk factors. CONCLUSIONS: Age ≤ 3 years old, frequent jerk or jitter, vomiting (> 3 times / d), poor circulation and high leukocytosis (> 15 × 109 / L) are highly correlated with the progression of HFMD as critically ill.