Risk factors for severe hand foot mouth disease in Singapore: a case control study.
Risk factors for severe hand foot mouth disease in Singapore: a case control study.
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DOI：
10.1186/s12879-015-1195-2
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发表时间：
2015-10-31
影响因子：
3.7
通讯作者：
Chan YH
中科院分区：
文献类型：
--
作者：
Chew SP;Chong SL;Barbier S;Matthew A;Lee JH;Chan YH
手足口病（HFMD）是一种常见的儿童感染，可能导致严重的并发症。本研究的目的是确定在我们的人群中获得严重手足口病的危险因素。我们对2004年8月至2014年7月在我院住院的患者进行了病例对照研究。病例为严重手足口病患者，对照组为同一年获得的年龄匹配的患者，比例为2:1。收集了包括人口学特征、临床症状和体征以及实验室结果在内的数据。采用条件单变量logistic回归来确定严重疾病的危险因素。共发现24例严重手足口病，并与48例对照进行匹配。17例（70.8%）出现中枢神经系统并发症。7例（29.2%）有心血管并发症，无心肌炎证据。一名患者死于脑炎。严重疾病的总死亡率为4%。血流灌注不足、癫痫发作、精神状态改变、脑膜刺激、心动过速、呼吸急促、绝对中性粒细胞计数升高和EV-A71（肠病毒A71）阳性与严重的手足口病病程显著相关。在治疗患有手足口病的儿童时，医生应该考虑这些因素，以帮助识别有严重疾病风险的患者。
Hand foot mouth disease (HFMD) is a common childhood infection that can potentially lead to serious complications. The aim of this study is to identify risk factors of acquiring severe HFMD in our population. We performed a case control study using patients admitted to our hospital from August 2004 to July 2014. Cases were patients with severe HFMD disease while controls were age-matched patients obtained from the same year, in a 2:1 ratio. Data comprising demographic characteristics, clinical symptoms and signs, and lab findings were collected. Conditional univariable logistic regression was performed to determine risk factors for severe disease. A total of 24 cases of severe HFMD were identified and matched with 48 controls. Seventeen (70.8 %) cases had central nervous system complications. Seven (29.2 %) had cardiovascular complications without evidence of myocarditis. One patient died of encephalitis. The overall mortality of severe disease is 4 %. Evidence of hypoperfusion, seizure, altered mentation, meningeal irritation, tachycardia, tachypnea, raised absolute neutrophil count and EV-A71 (Enterovirus A71) positivity were significantly associated with a severe course of HFMD. In managing children with HFMD, physicians should consider these factors to help identify patients at risk for severe disease.