Clinical Characteristics Of 485 Children With Hand,Foot And Mouth Disease

Objectives Observation analysis 485 cases of children with hand,foot and mouth disease(HFMD)clinical characteristics,laboratory examination and other indicators,it can be divided into normal group(not encephalitis)and severe group(group merger encephalitis),summary analysis way and the differences and relations between severe set of hand,foot and mouth disease,for hand,foot and mouth disease,especially of diagnosis and treatment of children with severe timely diagnosis and treatment to provide new train of thought,at the same time for hand,foot and mouth disease prevention to provide positive and effective measures.Methods A total of 485 cases of hand-foot-mouth disease were collected from the pediatric ward of Hebei General hospital from September 2016 to December 2018,including 244 males and 241 females,with a male to female ratio of about 1.01:1.The patients were aged 0.5 to 6 years old,with an average age of 2.13 years old and 426 cases younger than 3 years old.According to whether the merger encephalitis were divided into normal group(not encephalitis group)329 cases,severe group(group merger encephalitis)of 97 cases of children with hand,foot and mouth disease common group and severe group clinical characteristics and laboratory results were retrospectively analyzed,through the SPSS software,using?~2 test,t test and comparing the difference between the two groups of rank and inspection,further to provide early warning for severe hand,foot and mouth disease,diagnosis and treatment insights for future treatment.Results1 Age and gender:the age of onset in the severe group was relatively small,accounting for 84.5%of the patients with the age<3years old.The rank sum test showed that the age difference between the two groups was statistically significant(P<0.05).The gender of severe cases was higher than that of ordinary cases,and the difference was not statistically significant(P>0.05).2 Number of fever cases and thermal peak:the number of fever cases was 329 in the ordinary HFMD group and 92 in the severe group,and the difference was statistically significant(P<0.05).Severe HFMD group hot peak(38.98+0.74)?,the average heat peak for HFMD group(38.47+0.85)?,comparing differences between two groups was statistically significant(P<0.05).3 Laboratory examination:white blood cell count,neutrophilic granulocyte percentage and C-Reactive Protein of the severe group were higher than that of the mild grou p,and the differences were statistically significant(P<0.05).There was no significant difference in hemoglobin(HGB)between the two groups(P>0.05).The percentage of serum myocardial enzyme profile elevation in children with severe HFMD was h igher than that in the normal group(P<0.05).The levels of myocardial enzymes(C K-MB),glutamic oxalacetic transaminase(AST),lactate dehydrogenase(LDH),and alp ha-hydroxybutyric dehydrogenase(?-HBDH)in the severe group were significantly higher than those in the normal group,with statistically significant differences(P<0.05).IgG level in severe group was higher than that in mild group,and the differenc e was statistically significant(P<0.05).IgA level in severe group was lower than tha t in mild group,and the difference was statistically significant(P<0.05).There was no significant difference in the levels of complement C3 and C4 between the mild group and the severe group(P>0.05).4 The increase of cerebrospinal fluid pressure in children with severe HFMD accounted for76.5%of the total number of cases,and the increase of white blood cell count in cerebrospinal fluid accounted for 56.8%of the total number of cases,and the increase of white blood cell count was mainly increased by mononuclear cells(80.4%),which basically conforms to the change characteristics of cerebrospinal fluid in viral encephalitis.5 Etiology:the positive cases of different types of enterovirus infection in the severe group and the general group were compared,and the difference was statistically significant(P<0.05).The increased percentage of enterovirus EV71 in the severe group was significantly higher than that of coxsackie A16,indicating that enterovirus EV71 is more likely to lead to severe hand and foot disease.In recent years,the pathogenic types of HFMD are changing in different ways,among which other enteroviruses(except enteroviruses EV71 and coxsackie virus A16)account for 81.9%of the incidence of HFMD,significantly increasing.Conclusions1 The results of this study showed that HFMD mostly occurred in children aged 3 years and below,and the age range from 1 to 3 years old was the high incidence age of HFMD in the severe group,with more boys than girls,so infants and young children should be paid attention to.2 The increase of peripheral white blood cell count,neutrophil percentage,c-reactive protein,thermal peak,myocardial enzyme spectrum(CK,CKMB,AST,LDH,?-HBDH)and other indicators in children with HFMD has important clinical reference value for the early diagnosis of severe HFMD,so early attention should be given.3 The positive rate of cerebrospinal fluid examination for severe hand-foot-mouth disease(HFMD)is more common,so children with neurological symptoms and signs should be timely and early cerebrospinal fluid examination,which is of certain significance for the early diagnosis and treatment of severe cases.4 The results showed that the body of children with hand-foot-mouth disease had some humoral immune dysfunction,and the defense ability of respiratory mucosal infection was reduced in the Severe group,and complement C3 and C4 were consumed.The more serious the illness was,the more obvious the complement consumption was.Therefore,early detection of changes in the immune function of children should provide important guidance for the judgment and treatment of severe hand foot and mouth disease.Figure 0;Table 6;Reference 86...