Clinical Analysis Of Enterovirus 71 Infection And Preliminary Study On Cognitive Ability Of Severe Patients Infected By EV71

Objective:(1)Analyzing and summarizing the clinical data of EV71 infected children to improve the level of diagnosis and treatment of EV71 infection further.(2)Through the assessment of the cognitive ability of severe patients infected by EV71,further cognizing the damage to the nervous system in children caused by EV71.Methods:(1)Collected and analyzed statistics about the clinical data of 146 children with hand foot mouth disease(HFMD)caused by EV71 infection in Children's Hospital Affiliated of Sochow University's infectious disease department.(2)Cognitive ability assessment was performed on part of the patient using the fourth edition of Wechsler Intelligence Scale for children(WISC-IV),and the results of cognitive ability assessment were analyzed to understand the influence of EV71 infection on intelligence of children.Combined with clinical analysis,the correlation was analyzed.Results:(1)146 cases of children with HFMD infected by EV71 were mainly male,98 males and 48 females,and the proportion of men and women was 2.04:1.45 cases(30.82%)had a clear contact history before the onset of the disease.(2)The clinical symptoms of EV71 infection often manifested by rashs,fever,some patients refused to be fed or have mouth pain.71 cases of HFMD severe group of children with clinical manifestations were fever(100%),rashs(100%),47 cases with startle(66.20%),39 cases of limb shaking(54.93%)and vomiting in 37 cases(52.11%),17 cases of headache(23.94%),6 cases of dizziness(8.45%),as for nervous system symptoms,most are neck resistance which have 28 cases(39.43%),Babinski syndrome in 8 cases(11.27%),Brudzinski syndrome in 6 cases(8.45%),Kernig syndrome in 4 cases(5.63%),3cases of limb paralysis(4.23%),convulsions had not found.(3)In severe HFMD encephalitis group,the mean value of white blood cells,blood glucose,complement C3,C4,Ig A Ig M,CD3-(CD16+56)+ in peripheral blood were higher than those of common HFMD group,P < 0.05,CD3+,CD3+CD4+ in severe group were lower than those of commonl group,P< 0.05,the platelet,s CRP,C4,Ig M,CD3+CD8+,CD3-CD19+,prealbumin have no statistical significance between the severe group and the ordinary group,P > 0.05,(4)In the fourth version of Wechsler Intelligence Scale for children,2.5 years old to 3 years old and 11 months age group,and 4 years old to 6 year old and 11 months age group,the EV71 infection critical illness group children's total scale scores were all lower than those of the ordinary severe group,P < 0.05,with statistical significance.Conclusion:1.The men patient of EV71 infected children in Suzhou area were more than women,and about 1/3 had contact history.2.Severe cases of EV71 infection were fever,many with waving dance,body shaking,vomiting,headache,dizziness,physical examination often find neck resistance,Babinsky sign,Kernig sign,Brudzinski sign,some children limb paralysis,a rare children with convulsions.3.After EV71 infection,the peripheral blood leukocytes were most normal or elevated,and the liver and kidney function and myocardial damage were less happend.EV71 infected people have immune dysfunction.There were significant differences in leukocyte,blood glucose,C3,Ig A,Ig M,CD3-(CD16+56)+,CD3+ and CD3+CD4+ in children with hand foot and mouth disease between the common group and the severe group.4.EV71 infection has a certain influence on children with severe HFMD.