Risk factors of severe hand, foot and mouth disease: A meta-analysis
Risk factors of severe hand, foot and mouth disease: A meta-analysis
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DOI：
10.3109/00365548.2014.907929
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发表时间：
2014-07-01
影响因子：
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通讯作者：
Zhu, Bao-Ping
中科院分区：
文献类型：
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作者：
Fang, Yirong;Wang, Shuiping;Zhu, Bao-Ping
背景：近年来，手足口病疫情呈上升趋势，且重症病例不断增多。我们进行了一项荟萃分析，以生成有关严重手足口病危险因素的大规模证据。方法：检索PubMed、Elsevier Science Direct、中国知网（CNKI）和万方（中文）以查找相关文章。所有分析均使用 Stata 11.0 进行。结果：我们对 19 项独立研究进行了荟萃分析。发烧持续时间 >= 3 天（优势比 (OR) 10.09，95% 置信区间 (CI) 6.22-16.35），体温 >= 37.5 摄氏度（OR 4.91，95% CI 1.26-19.18），嗜睡（OR 7.75，95% CI 3.78-15.89），高血糖（或 2.77，95% CI 2.06-3.71）、呕吐（OR 8.83，95% CI 1.05-74.57）、中性粒细胞计数增加（加权平均差（WMD）0.61，95% CI 0.52-0.70）、肠道病毒 71 (EV71) 感染（OR 5.13，95% CI 3.11-8.46）、年轻（WMD -0.44，95% CI -0.69至-0.19）和家庭护理（OR 1.65，95% CI 1.26-2.17）与严重手足口病的风险显着相关。我们还发现，首次入院确诊可显着降低严重手足口病的风险（OR 0.30，95% CI 0.09-0.99）。我们没有发现口腔皮疹（OR 1.07，95% CI 0.82-1.39）、白细胞计数增加（WMD 0.51，95% CI -0.05-1.06）、男性（OR 1.06，95% CI 0.91-1.24）或居住在农村地区（OR 1.39，95% CI）之间存在关联。 0.95-2.02）和严重的风险 手足口病。结论：发热时间≥3天、体温≥37.5℃、嗜睡、高血糖、呕吐、中性粒细胞计数升高、EV71感染、年龄年轻是重症手足口病的危险因素。首次到医院确诊可显着降低患严重手足口病的风险。
Background: In recent years, outbreaks of hand, foot and mouth disease (HFMD) have increased, and more and more severe cases have appeared. We conducted a meta-analysis to generate large-scale evidence on the risk factors of severe HFMD. Methods: PubMed, Elsevier Science Direct, China National Knowledge Infrastructure (CNKI), and Wanfang (Chinese) were searched to identify relevant articles. All analyses were performed using Stata 11.0. Results: We conducted a meta-analysis of 19 separate studies. Duration of fever >= 3 days (odds ratio (OR) 10.09, 95% confidence interval (CI) 6.22-16.35), body temperature >= 37.5 degrees C (OR 4.91, 95% CI 1.26-19.18), lethargy (OR 7.75, 95% CI 3.78-15.89), hyperglycemia (OR 2.77, 95% CI 2.06-3.71), vomiting (OR 8.83, 95% CI 1.05-74.57), increased neutrophil count (weighted mean difference (WMD) 0.61, 95% CI 0.52-0.70), enterovirus 71 (EV71) infection (OR 5.13, 95% CI 3.11-8.46), young age (WMD -0.44, 95% CI -0.69 to -0.19), and home care (OR 1.65, 95% CI 1.26-2.17) were significantly related to the risk of severe HFMD. We also found that a confirmed diagnosis at first visit to hospital significantly decreased the risk of severe HFMD (OR 0.30, 95% CI 0.09-0.99). We did not find an association between oral rash (OR 1.07, 95% CI 0.82-1.39), increased leukocyte count (WMD 0.51, 95% CI -0.05-1.06), male sex (OR 1.06, 95% CI 0.91-1.24), or living in a rural area (OR 1.39, 95% CI 0.95-2.02) and the risk of severe HFMD. Conclusions: Duration of fever >= 3 days, body temperature >= 37.5 degrees C, lethargy, hyperglycemia, vomiting, increased neutrophil count, EV71 infection, and young age are risk factors for severe HFMD. A confirmed diagnosis at first visit to hospital can significantly decrease the risk of severe HFMD.