Song Chun-Lan, Cheng Yi-Bing, Chen Dan, Gu Xue, Li Hai-Bei, Yan Xiao-Qing
Department of Intensive Care Unit II, Zhengzhou Children′s Hospital, Zhengzhou 450003, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2014 Oct;16(10):1033-6.
To study the death risk factors in children with severe hand, foot and mouth disease (HFMD).
A total of 164 children with severe HFMD between May 2010 and September 2012 were recruited and classified into death and survival groups according to their prognosis. The differences in general information, clinical signs and symptoms and laboratory examinations were compared between the two groups. The multivariate logistic regression analysis was used to identify death risk factors in children with severe HFMD.
There were significant differences in the incidences of atypical rash, persistent fever, dyspnea, pulmonary hemorrhage, heart rate increase, blood pressure abnormalities, cold sweat, capillary refill time>3 seconds and frequent seizures, and blood glucose, serum creatine kinase and serum lactate levels between the death and the survival groups (P<0.05). The multivariate logistic regression analysis showed three independent death risk factors for children with severe HFMD: pulmonary hemorrhage (OR=9.466, 95%CI: 1.786-21.256), abnormal blood pressure (OR=5.224, 95%CI: 1.012-28.985) and elevated serum lactate level (OR=2.154, 95%CI: 1.020-8.253).
Pulmonary hemorrhage, abnormal blood pressure and elevated serum lactate are major death risk factors for children with severe HFMD.
研究重症手足口病（HFMD）患儿的死亡危险因素。
选取2010年5月至2012年9月期间共164例重症手足口病患儿，根据预后分为死亡组和存活组。比较两组患儿的一般资料、临床症状体征及实验室检查结果的差异。采用多因素logistic回归分析确定重症手足口病患儿的死亡危险因素。
死亡组和存活组在非典型皮疹、持续发热、呼吸困难、肺出血、心率增快、血压异常、冷汗、毛细血管再充盈时间>3秒及频繁惊厥的发生率，以及血糖、血清肌酸激酶和血清乳酸水平方面存在显著差异（P<0.05）。多因素logistic回归分析显示，重症手足口病患儿的三个独立死亡危险因素为：肺出血（OR=9.466，95%CI：1.786-21.256）、血压异常（OR=5.224，95%CI：1.012-28.985）和血清乳酸水平升高（OR=2.154，95%CI：1.020-8.253）。
肺出血、血压异常和血清乳酸水平升高是重症手足口病患儿的主要死亡危险因素。
