To Analyze The Risk Factors Of Severe Hand Foot Mouth Disease (HFMD) And Build A Risk Assessment Model

Background:Hand foot and mouth disease is an acute childhood infectious disease caused by enterovirus.It is common in children under 5 years old.The hand and foot with rash and oral mucosa ulcer for herpes or features,the most favorable prognosis.A few cases of severe cases,such as encephalitis,pulmonary edema,and circulatory disorders,have been progressing rapidly.After active intervention,there is still heart and lung failure,and the mortality rate is high.How to effectively reduce the mortality of patients with severe hand foot and mouth disease（HFMD）in clinical early,should be combined with clinical treatment on the basis of in-depth study and summarize a systematic and scientific system of clinical prevention and treatment,which has important economic and social benefits.Objective:To analyze the risk factors of severe hand foot mouth disease（HFMD）and build a risk assessment model.Method:A total of 443 children who met the diagnostic criteria of hand foot and mouth disease in Jiangxi Province children hospital infection department from September2016 to February 2017 were enrolled.There were 282 boys（63.66%）and 161 girls（36.34%）,with an average age of 18（1--148）months.The multivariate linear regression analysis of epidemiological factors,intestinal virus infection factors,immune cell factors,immunoglobulin factors,cortisol factors and cytokine factors was made to construct their correlation model for the degree of disease,and to find the main related factors that affect the severity of the disease.Finally,according to the Delphi method of comprehensive evaluation,the weight values of different factors affecting the severity of the disease were determined,and a comprehensive evaluation model was built to influence the severity of the disease.Results:The epidemiology of severe children,71 infection of enterovirus,?-endorphin,immunoglobulin,immunoglobulin,cortisol were strongly correlated（the correlation coefficient R² was close to 1,the corresponding probability P<0.05）,and the correlation of cytokines was weak（R² was close to 0,P>0.05）.Comprehensive evaluation model:F=-0.1424-0.0014L₁-0.0030L₂-0.0167L₄-0.0118L₅+0.0252L₆+0.1669EV71+0.0828β-EP+0.0113COR-0.0038CD16+56-0.0045CD4-0.0047CD8+0.0071CD19-0.0075CD3-0.0059CD4/CD8+0.0082IgM+0.0006IgG+0.0011IgA。Conclusion:The epidemiology of severe children（age,sex,first diagnosis hospital type,basic disease,birth weight）,enterovirus 71 infection,?-endorphin（?-EP）,immune cells（CD3,CD4,CD8,CD19,CD16+56,CD4/CD8）,immunoglobulin（IgM,IgG,IgA）,and cortisol（COR）are strongly correlated.The comprehensive evaluation model based on this model has high efficiency.