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目的分析山东省泰安市2011年1月至12月儿童手足口病(HFMD)的临床流行病学特征。方法对1406例手足口病患儿的临床资料进行临床流行病学和病原学分析。结果 1406例患儿中男938例,女648例;年龄<1岁56例(3.98%),1～3岁1036例(73.68%),3～6岁252例(17.92%),>6岁56例(3.98%)。手足口病疫情全年均有报告,5～7月为高峰期,7月达最高峰,11月为全年第2高峰,1月最低。989例经外周血EV71-IgM和咽拭子DNA-PCR法进行病原学检测,EV71阳性248例(24.07%),CoxA16阳性505例(51.06%)。轻症病例998例,重症病例351例。1121(80.07%)并发心肌损害,295例(21.07%)并发肺炎,51例(3.64%)并发肝功能损害。351例重症病例中,脑膜炎、脑炎333例,脑脊髓炎9例,肺水肿5例,循环障碍4例;痊愈339例,后遗症10例,死亡2例。结论 HFMD的早期发现、及时诊断、有效治疗可改善预后。
Objective To analyze the clinical epidemiological characteristics of hand, foot and mouth disease (HFMD) in children from January to December 2011 in Tai’an City, Shandong Province. Methods The clinical data of 1406 children with HFMD were analyzed by clinical epidemiology and etiology. Results A total of 938 males and 648 females were enrolled in this study. A total of 648 males (1.98%) were aged <1 year old, 1036 (73.68%) were aged 1-3 years, 252 (17.92%) were aged 3-6 years old, 56 cases (3.98%). Hand, foot and mouth disease outbreaks are reported throughout the year, 5 to July for the peak, the highest peak in July, November is the second peak of the year, the lowest in January. A total of 989 EV71-IgM and throat swab DNA-PCR methods were used to detect the etiology. There were 248 EV71 positive cases (24.07%) and 505 CoxA16 positive cases (51.06%). 998 mild cases, 351 severe cases. 1121 (80.07%) complicated with myocardial damage, 295 cases (21.07%) complicated with pneumonia and 51 cases (3.64%) with liver dysfunction. Of the 351 severe cases, meningitis, encephalitis 333, encephalomyelitis 9, pulmonary edema 5, and circulatory disturbance 4; 339 recovered, 10 sequelae and 2 died. Conclusion Early detection of HFMD, timely diagnosis and effective treatment can improve the prognosis.