Fang Yirong, Wang Shuiping, Zhang Lijie, Guo Zhinan, Huang Zhaohui, Tu Chunyu, Zhu Bao-Ping
From the 1 Department of Infectious Disease, Shaoxing Center for Disease Control and Prevention , Shaoxing.
Scand J Infect Dis. 2014 Jul;46(7):515-22. doi: 10.3109/00365548.2014.907929. Epub 2014 May 16.
In recent years, outbreaks of hand, foot and mouth disease (HFMD) have increased, and more and more severe cases have appeared. We conducted a meta-analysis to generate large-scale evidence on the risk factors of severe HFMD.
PubMed, Elsevier Science Direct, China National Knowledge Infrastructure (CNKI), and Wanfang (Chinese) were searched to identify relevant articles. All analyses were performed using Stata 11.0.
We conducted a meta-analysis of 19 separate studies. Duration of fever ≥ 3 days (odds ratio (OR) 10.09, 95% confidence interval (CI) 6.22-16.35), body temperature ≥ 37.5°C (OR 4.91, 95% CI 1.26-19.18), lethargy (OR 7.75, 95% CI 3.78-15.89), hyperglycemia (OR 2.77, 95% CI 2.06-3.71), vomiting (OR 8.83, 95% CI 1.05-74.57), increased neutrophil count (weighted mean difference (WMD) 0.61, 95% CI 0.52-0.70), enterovirus 71 (EV71) infection (OR 5.13, 95% CI 3.11- 8.46), young age (WMD - 0.44, 95% CI - 0.69 to -0.19), and home care (OR 1.65, 95% CI 1.26-2.17) were significantly related to the risk of severe HFMD. We also found that a confirmed diagnosis at first visit to hospital significantly decreased the risk of severe HFMD (OR 0.30, 95% CI 0.09-0.99). We did not find an association between oral rash (OR 1.07, 95% CI 0.82-1.39), increased leukocyte count (WMD 0.51, 95% CI - 0.05-1.06), male sex (OR 1.06, 95% CI 0.91-1.24), or living in a rural area (OR 1.39, 95% CI 0.95-2.02) and the risk of severe HFMD.
Duration of fever ≥ 3 days, body temperature ≥ 37.5°C, lethargy, hyperglycemia, vomiting, increased neutrophil count, EV71 infection, and young age are risk factors for severe HFMD. A confirmed diagnosis at first visit to hospital can significantly decrease the risk of severe HFMD.
近年来，手足口病（HFMD）疫情有所增加，出现了越来越多的重症病例。我们进行了一项荟萃分析，以获取关于重症手足口病危险因素的大规模证据。
检索了PubMed、爱思唯尔科学Direct、中国知网（CNKI）和万方（中文）以识别相关文章。所有分析均使用Stata 11.0进行。
我们对19项独立研究进行了荟萃分析。发热持续时间≥3天（优势比（OR）10.09，95%置信区间（CI）6.22 - 16.35）、体温≥37.5°C（OR 4.91，95% CI 1.26 - 19.18）、嗜睡（OR 7.75，95% CI 3.78 - 15.89）、高血糖（OR 2.77，95% CI 2.06 - 3.71）、呕吐（OR 8.83，95% CI 1.05 - 74.57）、中性粒细胞计数增加（加权平均差（WMD）0.61，95% CI 0.52 - 0.70）、肠道病毒71型（EV71）感染（OR 5.13，95% CI 3.11 - 8.46）、低龄（WMD - 0.44，95% CI - 0.69至 - 0.19）以及居家护理（OR 1.65，95% CI 1.26 - 2.17）与重症手足口病风险显著相关。我们还发现首次就诊时确诊可显著降低重症手足口病风险（OR 0.30，95% CI 0.09 - 0.99）。我们未发现口腔皮疹（OR 1.07，95% CI 0.82 - 1.39）、白细胞计数增加（WMD 0.51，95% CI - 0.05 - 1.06）、男性（OR 1.06，95% CI 0.91 - 1.24）或居住在农村地区（OR 1.39，95% CI 0.95 - 2.02）与重症手足口病风险之间存在关联。
发热持续时间≥3天、体温≥37.5°C、嗜睡、高血糖、呕吐、中性粒细胞计数增加、EV71感染以及低龄是重症手足口病的危险因素。首次就诊时确诊可显著降低重症手足口病风险。
