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目的:探讨手足口病(HFMD)患儿的流行特征及临床特点。方法:回顾性分析2011年1月-2011年12月本院诊治的1260例手足口病的临床资料,对其中548例患儿治疗前及痊愈时白细胞数(WBC)、血糖值(Glu)、血浆肿瘤坏死因子(TNF-α)及白细胞介素10(IL-10)水平进行检测,并与50例健康婴幼儿为对照组,比较其变化。结果:手足口病发病的男:女为1.29:1,以5岁以下多见;全年均发病,主要集中在5-7月份;大多数为普通病例,预后好;重症病例均为肠道病毒71(EV71)型感染,2例出现神经源性肺水肿而死亡。与正常对照组比较,HFMD组WBC、TNF-α均明显增高,IL-10水平明显降低,P均<0.01;出院时上述各指标降至正常,与对照组相比无明显差异,P>0.05。结论:本病的传染性强,传播速度快,短时间内可在幼儿园、社区等人口密集的地区引起大流行,做到早发现,早隔离,早治疗以期降低手足口病发病率;重症病例起病急,临床表现不典型,进展迅速,早期识别危重症候并给予积极干预治疗至关重要。HFMD患儿存在WBC、Glu升高及细胞因子水平的异常。
Objective: To investigate the prevalence and clinical features of children with HFMD. Methods: The clinical data of 1260 hand, foot and mouth disease diagnosed and treated in our hospital from January 2011 to December 2011 were analyzed retrospectively. The WBC, Glu, Plasma levels of tumor necrosis factor (TNF-α) and interleukin-10 (IL-10) were measured and compared with 50 healthy infants as control group. Results: The incidence rate of hand-foot-mouth disease was 1.29: 1 for females and 1. 5 for females. The incidence of hand-foot-mouth disease was more common in patients younger than 5 years. The incidence of hand-foot-mouth disease was mainly in May-July. Most cases were common and the prognosis was good. Infectious virus 71 (EV71) type, 2 patients died of neurogenic pulmonary edema. The levels of WBC and TNF-α in HFMD group were significantly higher than those in normal control group (P <0.05), and the levels of IL-10 in HFMD group were significantly lower than those in control group . Conclusion: The disease is contagious and has a fast transmission speed. It may cause a pandemic in a densely populated area such as kindergarten and community within a short period of time so that early detection, early isolation and early treatment can reduce the incidence of HFMD. Severe cases Urgency, clinical manifestations of atypical, rapid progress, early identification of critical illness and give positive intervention in treatment is essential. HFMD children with WBC, Glu increased and abnormal cytokine levels.