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[摘要] 手足口病是由多种肠道病毒引起的急性传染病，多发生于学龄前儿童，以发热和手、足、口腔等部位的皮疹或疱疹为主要特征，而部分重症手足口病患儿可出现多系统损害，极少数病例病情危重可死亡。我院感染科收治1例手足口病出现严重肝功能异常、心肌损伤的患儿，现回顾性分析患儿的诊治经过并进行文献复习，提高对该病合并肝功能异常、心肌损伤的认识及诊治，早期发现重型病例，早期進行干预治疗，以降低病死率。

[关键词] 手足口病；肝功能；心律失常；心肌酶

[中图分类号] R725.1 [文献标识码] B [文章编号] 1673-9701（2017）02-0139-03

Report of one case of hand-foot-and-mouth disease causing severe liver disfunction with myocardial injury and review of the literature

YAN Fei TANG Yongzhi LI Ali ZHU Jiansheng ZENG Wenxin CHEN Huazhong

Department of Infectious Diseases，Taizhou Hospital of Zhejiang Province，Linhai 317000，China

[Abstract] Hand-foot-and-mouth disease （HFMD） is a childhood infectious disease that is principally caused by various enteroviruses. HFMD is characterized by fever， skin eruptions on the hands and feet， and vesicles in the mouth； systemic syndromes and even death that can be fatal occur in some patients. The case of HFMD causing severe liver disfunction and myocardial injury received a child patient in the department of infectious diseases in our hospital. At present， we analyzed the diagnosis process retrospectively， in order to improve the knowledge of HFMD causing severe liver disfunction and myocardial injury. We can detect the severe cases in the early time， then we can carry out early and timely treatment， in order to achieve lower mortality.

[Key words] Hand-foot-and-mouth disease；Liver function；Arrhythmia；Myocardial enzyme

手足口病（hand-foot-and-mouth disease， HFMD） 是由多种肠道病毒引起的急性传染病，具有传播迅速、传染性强等特点，引起该病的肠道病毒约有 20 种，其中以柯萨奇病毒 A 组 16 型（CoxA16）、肠道病毒 71 型（Enterovirus 71， EV71）为最常见病原体[1]，多发生于学龄前儿童，特别是5岁以下儿童。手足口病以发热和手、足、口腔等部位的皮疹或疱疹为主要特征，大部分轻症患者可在3～5 d 左右自愈，而部分重症手足口病患儿可出现脑炎、脑膜炎、脑脊髓膜炎、肺水肿、心衰等，病情凶险，极少数病例病情危重，可致死亡[2-5]，但手足口病引起严重肝功能异常、窦性心律不齐鲜有报道。本文诊治1例手足口病引起肝功能严重异常及心律失常患儿，并结合相关文献进行复习，现报道如下。

1 临床资料

患儿男，1岁。主因“皮疹2 d”于2016年9月18日入院。患儿2 d前出现手、足、臀红色皮疹，口腔内散在疱疹及溃疡，伴食欲减退，无发热畏寒、无嗜睡易惊、无恶心呕吐等，遂至当地医院住院，患儿于手足口病流行季节发病，有手足口病接触史。……