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目的:估测不同病原型别手足口病患儿发病至确诊间隔时间并探讨其对间隔时间的影响。方法:选取2010年1月-2014年12月期间经广州市妇女儿童医疗中心实验室确诊的1367例手足口病患儿为研究对象;采用非参数Kruskal-Wallis H检验和Logistic回归分析病原型别对间隔时间的影响。结果:不同病原型别手足口病患儿间隔时间呈正偏态分布,中位数为2.38天(四分位数:1.38-2.83),且从“CV-A16(1.79天)→EV71(2.38天)→其它型别(2.45天)”逐渐延长(P<0.001)。多因素回归分析结果显示:与CV-A16型别相比,EV71型别(OR=1.46,95%CI:1.05-2.02)和其它型别(OR=1.92,95%CI:1.52-2.44)可显著增加间隔时间>2天的风险。结论 :绝大多数手足口病患儿无法在当天得到实验室确诊,需要进一步提高实验室确诊能力和病原型别鉴定能力。
OBJECTIVE: To estimate the time between onset of diagnosis and diagnosis of hand-foot-mouth disease in children with different pathogenicity and to explore the influence of it on the interval time. Methods: A total of 1367 children with hand-foot-mouth disease confirmed by laboratory of Guangzhou Women and Children’s Medical Center from January 2010 to December 2014 were selected as the research objects. Non-parametric Kruskal-Wallis H test and Logistic regression were used to analyze the pathogen types Impact on interval time. Results: The distribution of hand-foot-mouth disease among children with different pathogenicity was positively skewed at a median of 2.38 days (quartile: 1.38-2.83), and from “CV-A16 (1.79 days) → EV71 Day) → other types (2.45 days) ”gradually extended (P <0.001). Multivariate regression analysis showed that the EV71 type (OR = 1.46, 95% CI: 1.05-2.02) and other types (OR = 1.92, 95% CI: 1.52-2.44) Significantly increased risk of interval> 2 days. Conclusion: Most hand-foot-mouth disease patients can not get the laboratory diagnosis on the same day, so it is necessary to further improve the laboratory diagnosis ability and pathogen type identification ability.