解放军医学杂志2025，Vol.50Issue(9)：1110-1116,7.DOI:10.11855/j.issn.0577-7402.0166.2025.0609
福州市手足口病重症患儿危险因素分析
Risk factor analysis for severe hand-foot-mouth disease cases in children in Fuzhou
摘要
Abstract
Objective To identify risk factors for severe hand-foot-mouth disease(HFMD)cases in Fuzhou,providing scientific evidence for disease prevention and control.Methods Severe pediatric HFMD cases in Fuzhou between 2017 and 2024 were collected from the"China Disease Prevention and Control Information System".Non-severe cases were frequency-matched based on the same onset period,same affected region,same parents'educational level,and age(±1 year)to form a non-severe group.Demographic characteristics,clinical symptoms,medical history,and pathogen types of both groups were collected.Logistic regression was used to identify the risk factors for severe cases.Results From 2017 to 2024,Fuzhou reported 503 severe HFMD cases and 1053 matched non-severe cases.Demographically,severe group had a higher proportion of home-based childcare,rural residence,care-seeking delay>2 d,while EV71 vaccination rates,handwashing habits before meals and after defecation,and caregivers with HFMD prevention education were lower than those in non-severe group,with statistically significant difference(P<0.001).Clinically,severe group showed more frequent fever>3 d,altered consciousness/seizure,limb tremors/convulsions,the proportion of infectious disease and the proportion of EV71-positive cases than those in non-severe group(P<0.001).Multivariate logistic regression analysis showed that home-based childcare(OR=3.213,95%CI 1.913-5.398),rural residence(OR=2.121,95%CI 1.513-2.973),lack of EV7 vaccination(OR=3.141,95%CI 1.996-4.945),care-seeking delay>2 d(OR=2.004,95%CI 1.410-2.849),no handwashing habits before meals and after defecation(OR=3.927,95%CI 1.718-5.356),caregiver without HFMD education(OR=2.465,95%CI 1.807-3.362),fever>3 d(OR=2.585,95%CI 1.801-3.709),altered consciousness/seizures(OR=4.059,95%CI 2.731-6.031),limb tremors/convulsions(OR=2.087,95%CI 1.398-3.117),history of infectious disease(OR=3.369,95%CI 1.725-6.335)and EV71 positivity(OR=3.854,95%CI 2.678-5.545)were risk factors for severe HFMD cases.The recovery time in severe group was significantly longer than that in non-severe group[18(5,32)d vs.11(4,23)d,P<0.001].Conclusions Prevention and control efforts should target high-risk groups by strengthening health education,promoting EV71 vaccination and improving the treatment of severe HFMD cases to reduce the incidence of severe HFMD.关键词
手足口病/重症病例/危险因素/Logistic回归/免疫接种Key words
hand-foot-and-mouth disease/severe case/risk factor/logistic regression/immune vaccination分类
医药卫生引用本文复制引用
郑霄雁,郑成浩,林风华,黄意坚,郑本汇源..福州市手足口病重症患儿危险因素分析[J].解放军医学杂志,2025,50(9):1110-1116,7.基金项目
This work was supported by the Fujian Province Major Scientific Research Project(2022ZD01001),the Guiding Project of Fujian Province Science and Technology Plan(2022D021),and the Major Scientific Research Fund on Health of Fujian(2021ZD0101) 福建省重大科研专项(2022ZD01001) （2022ZD01001）
福建省科技计划引导性项目(2022D021) （2022D021）
福建省卫生健康重大科研专项基金(2021ZD0101) （2021ZD0101）
