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儿童手足口病合并肝损害的特点及相关因素分析
花兵,董文斌,陈日金,张桂芹,刘伟东
0
(盐城市妇幼保健院儿科;西南医科大学附属医院新生儿科)
摘要:
探讨儿童手足口病合并肝损害的特点,并对其可能的相关因素进行分析,从而增加对手足口病合并肝损害的认识。方法 回顾性分析江苏省盐城市妇幼保健院儿科2015年1月~2018年1月收治的57例手足口病患儿的临床资料,根据是否有肝损害,分为肝损害组(n=19)和对照组(n=38)。记录患儿血常规、CRP、肝功能等指标,同时根据多元回归分析对两组患儿进行对照分析,并总结合并肝损害患儿的临床特点。结果 57例手足口病患儿中,肝损害者19例(33.3%),其中13例患儿ALT升高在200u/L以内,约占68.4%。两组患儿ALT、AST、GGT、WBC及CRP水平比较,差异有统计学意义(P<0.05);多元素Logistic回归分析结果显示,WBC、ALT进入回归模型。结论 WBC升高与肝损害呈正相关,与年龄、性别无明显差异,应提高重视,尽早干预治疗。
关键词:  儿童  手足口病  肝损害  相关因素
DOI:
基金项目:
Clinical features and related factors for hand, foot and mouth disease with liver damage
HUA Bing,DONG Wenbin,CHEN Rijin,ZHANG Guiqin,LIU Weidong
(Department of Pediatric, Yancheng Maternal and Child Health Care Center;Department of Neonatology, The Affiliated Hospital of Southwest Medical University)
Abstract:
Objective To study the features of hand, foot and mouth disease (HFMD) with liver damage and investigate the possible related factors and improve the understanding of liver damage in HFMD patients. Methods The clinical data of 57 HFMD patients admitted from 2015 to 2018 were collected to retrospectively analyze the clinical features of liver damage, as well as routine blood test, C-reactive protein (CRP), liver function. Categorical data were analyzed by chi-square test. Continuous data were expressed as mean±standard deviation; comparison between groups was made by t test and multivariate stepwise regression analysis. Results The incidence of abnormal alanine aminotransferase (ALT) level in 57 cases was 33.3%, and 68.4% of these patients had a serum ALT level of less than 200 IU /L. Platelet count were not found to be related to liver damage ( t=1.65, P=0.105 ). There was significant difference in white blood cell (WBC) count and CRP between patients with liver damage and controls ( t=3.86, P=0.001; t=2.36, P=0.022). Simultaneous increase in WBC count was significantly associated with an increased risk of liver damage (P<0.05). Conclusion CRP and platelet count are not found to be significantly related to the development of liver damage, but there is a close relationship between liver damage and WBC count. WBC count shows a certain relationship with liver damage. Clinicians should pay attention to these factors and take timely measures for intervention.
Key words:  Children  Hand, foot and mouth disease  Liver damage

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