【摘要】 目的探讨影响手足口病重症及流行的相关因素,为制定手足口病防制策略提供科学依据。方法 2013年保定市手足口病疫情报告共12 816例,对发病率、时间分布、地区分布、性别、年龄及职业分布进行回顾性分析。其中171例病原学检测EV71与Cox A16阳性的患者临床资料采用χ2检验和t检验进行统计学分析。结果 2013年全市27个县市区报告病例前5位的县占总报告病例的46.66%。发病高峰为4~7月份(占71.91%)。5岁以下散居儿童为主(占99.37%);男性较女性患儿多(60.78%vs 39.22%)。发病以EV71型感染为主,EV71与Cox A16两组从低龄儿童发病人数、易惊、呕吐和皮疹等临床表现,以及胸片、血糖等辅助检查方面差异无统计学意义。但EV71组体温(39.32±0.89)℃高于Cox A16组(38.79±0.68)℃(t=4.273、P=0.000);WBC总数EV71组的(9.43±3.98)×109/L高于Cox A16组的(7.56±4.37)×109/L(t=2.920、P=0.004);EV71组总病程为(10.5±4.4)d,Cox A16组为(8.6±3.3)d(t=2.920、P=0.004),EV71组病程长于Cox A16组,两组间差异具有统计学意义。结论 2013年保定市手足口病以5岁以下的散居儿童和托幼儿童为主,男童多于女童。病原体主要为EV71和Cox A16,EV71组患儿病情相对较重。对低龄儿童发病高峰到来前做好各项预防控制措施,是预防工作的重点。医疗机构密切观察病情、行病原学检测,有助于早期识别重症病例,降低病死率及后遗症的发生率。更多还原

【Abstract】 Objective To explore the factors related to the prevalence of hand, foot and mouth disease(HFMD) and to provide scientific basis for developing prevention and control strategy of HFMD. Methods In 2013, a total of 12 816 cases with HFMD in Baoding City were reported. The incidence, time distribution, regional distribution, gender, age and occupation distribution were analyzed, retrospectively. There were 171 cases with EV71 and Cox A16 positive, the clinical data were statistically analyzed with χ2 test and t test. Results In 2013, the top 5 counties reported 46.66% of total reported cases among 27 counties in Baoding Ctiy. The peak incidence occurred in April to July(71.91%). Most of the cases were children under 5 years old(99.37%) and boys were more vulnerable than girls(60.78% vs 39.22%). EV71 infection was more common and there was no difference between the EV71 group and Cox A16 group in clinical symptoms as easily frightened, vomiting, rash, chest X-ray, the blood glucose and other auxiliary examinations. However, there were significant difference between the two groups in temperature(39.32 ± 0.89) ℃ in EV71 group vs(38.79 ± 0.68) ℃ in Cox A16 group(t = 4.273, P = 0.000); WBC(9.43 ± 3.98) × 109/L in EV71 group vs(7.56 ± 4.37) × 109/L in Cox A16 group(t = 2.920, P = 0.004); the disease duration was(10.5 ± 4.4) d in EV71 group vs(8.6 ± 3.3) d in Cox A16 group(t = 2.920, P = 0.004). The difference between the two groups was statistically significant. Conclusions In 2013, HFMD mainly affected children under age 5 and boy cases were more than girl cases in Baoding City. The main pathogens were EV71 and Cox A16. EV71 group patients were more severe. Prevention and control measures should be taken before the arrival of the peak incidence. Close observation of the disease and pathogen detection contribute to the early recognition of severe cases then reducing the mortality and sequelae.更多还原