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目的探讨重症手足口病的危险因素,为今后开展该病防治工作提供科学依据。方法以北京市海淀区2010—2011年度发生的手足口病例为研究对象,选择重症病例(病例组)和普通病例(对照组)各56例,通过病例报告卡资料数据进行病例对照研究,采用单因素和多因素logistic回归分析探讨重症手足口病的危险因素。结果单因素分析显示,重症病例组和对照组在年龄、性别、病毒类型构成、初诊医院方面的差异无统计学意义(P>0.05),入园状态、就诊时间的构成比差异具有统计学意义(P<0.05),提示这些因素可能是感染重症手足口病的危险因素。多因素分析显示,影响重症手足口病的危险因素是入园状态、就诊时间、就诊医院(P<0.05),与户籍、年龄、感染病毒的类型无关(P>0.05)。结论托幼机构、学校、环境卫生状况等对重症手足口病的发生起重要影响。疾病预防控制机构应对家长和学校进行健康教育,发现可疑患者应及时就医,对该病无诊疗能力的医疗机构应对患儿及时转诊,避免贻误病情。
Objective To explore the risk factors of HFMD and provide a scientific basis for future prevention and treatment of the disease. Methods Hand-foot-mouth cases occurred in 2010-2011 in Haidian District, Beijing were selected as the study subjects. Fifty-six cases of severe cases (case group) and common cases (control group) were selected. A case-control study was conducted by using case report card data. Factors and multivariate logistic regression analysis of risk factors for HFMD. Results Univariate analysis showed that there was no significant difference in the age, sex, type of virus and newly diagnosed hospital between the severe case group and the control group (P> 0.05), and there was a significant difference in the constituent ratio between admission status and treatment time (P <0.05), suggesting that these factors may be the risk factors for severe HFMD. Multivariate analysis showed that the risk factors influencing HFMD were admission status, visiting time and visiting hospital (P <0.05), but not related to household registration, age and the type of infectious virus (P> 0.05). Conclusion The nurseries, schools, sanitation status and so on have an important impact on the occurrence of severe hand-foot-mouth disease. Disease prevention and control institutions should conduct health education for parents and schools, found that suspicious patients should seek medical treatment promptly, the medical institutions without medical treatment capacity for this disease should timely referral to children, to avoid delaying the disease.