郑州市2015年至2019年手足口病患者外周血炎症细胞和电解质水平变化与预后关联的巢式病例对照研究

Nest case-control study of the correlation between changes in peripheral blood inflammatory cells and electrolyte levels and prognosis of hand-foot-mouth disease in Zhengzhou from 2015 to 2019

摘要:

目的 探讨血清炎症细胞和电解质水平变化与手足口病（hand-foot-mouth disease，HFMD）严重程度相关性。方法 采用巢式病例对照研究，选取2015年至2019年于河南省儿童医院住院的HFMD患儿为研究对象，绘制趋势图进行对比，并构建logistic回归模型预测手足口病重症化的危险因素。结果 logistic回归多因素分析中炎症细胞（白细胞、中性粒细胞比率、血小板计数）增加在轻、重症HFMD病程第1~3天差异有统计学意义（P<0.05）；电解质水平改变（K⁺升高、Ca²⁺和Na⁺降低）在轻、重症HFMD病程第2~5天差异有统计学意义（P<0.05）；重症HFMD组中居住地为农村、高热的比率明显高于普通HFMD组（P<0.05）。结论 炎症细胞（白细胞、中性粒细胞比率、血小板计数）增加和电解质水平改变（K⁺升高、Ca²⁺和Na⁺降低）可提示重症HFMD不同病程的进展，监测HFMD患者病程中外周血炎症细胞和电解质水平变化具有一定的临床价值，应加强对居住地为农村和高热HFMD患者的健康管理。

Abstract:

Objective To explore the correlation between serum inflammatory cells and electrolyte levels and the severity of hand-foot-mouth disease（HFMD）.Methods Using the Nest case-control study，we selected children hospitalized in Henan Children's Hospital from 2015 to 2019 as research objects， mapped a trend chart for comparison， and built a logistic regression model to predict the risk factors of severe HFMD.Results Multivariate logistic regression analysis showed that the increase of inflammatory cells（leukocyte， neutrophil ratio，platelet count） in the course of mild and severe HFMD（day 1 to day 3） was statistically significant（P<0.05）. The changes of electrolyte levels（increased K⁺，decreased Ca²⁺ and Na⁺） in the course of mild and severe HFMD（day 2 to day 5） was statistically significant（P<0.05）. The rate of high fever in severe HFMD group was significantly higher than that in common HFMD group（P<0.05）.Conclusion The increase of inflammatory cells（leukocyte， neutrophil ratio and platelet count） and the change of electrolyte levels（K⁺ increase，Ca²⁺ and Na⁺ decrease） can indicate the progression of severe HFMD. Monitoring the changes of inflammatory cells and electrolyte levels in peripheral blood of patients with HFMD during the course of the disease has certain clinical value. Health management of HFMD patients with high fever who live in rural areas should be strengthened.