流感监测中儿童流感样病例定义探讨  

Study on case definition of influenza like illness in children for influenza surveillance

作　　者：朱洪浩[1] 刘传楠[1] 林新明[1] 周玉[1] 胡冬林[2] 聂绍发[3] 

机构地区：[1]武汉市疾病预防控制中心 [2]武汉市儿童医院,湖北武汉430016 [3]华中科技大学同济医学院流行病与卫生统计学系,湖北武汉430030

出　　处：《疾病控制杂志》2007年第6期557-559,共3页Chinese Journal of Disease Control and Prevention

摘　　要：目的探讨流感监测中儿童流感样病例的定义。方法对武汉地区1994～2004年的流感监测资料进行回顾性统计分析。结果在1003例研究对象中301例(30.01%)被证实存在流感病毒感染,两个年龄组的流感发病率差异有统计学意义(P=0.024),A型和B型流感病毒感染后"卡他症状"(P=0.0242)和"咽痛"(P=0.0091)的出现率差异有统计学意义;进入logistic回归模型的5个变量为:体温(OR=1.555)、发病天数(OR=0.591)、咳嗽(OR=2.369)、卡他症状(OR=1.873)、咽痛(OR=2.061);用"咳嗽伴有卡他症状或咽痛"症状组合预测儿童流感感染的阳性预测值为41.3%,阴性预测值为78.4%,灵敏度为58.8%,特异度为64.1%。结论流感监测中儿童流感样病例较科学合理定义为:发热(体温≥38℃)、咳嗽并伴有卡他症状或咽痛之一者。Objective To probe into the case definition of influenza like illness （ILI） in children for influenza surveillance. Methods Retrospective analysis was conducted on the influenza surveillance data of Wuhan area from 1994 to 2004. Results Of 1 003 subjects selected in this study, 301（30.01% ） were confirmed to have influenza. The incidence of influenza was significantly different between two age groups （P = 0.024）. Nasal symptoms （P = 0. 0242） and sore throat （P = 0. 0091 ） were significantly different between the infections of influenza A and influenza B viruses. Temperature （ OR = 1. 555）, duration of symptoms （ OR = 2. 369）, cough （ OR = 2. 369）, nasal symptoms （ OR = 1. 873）, and sore throat （ OR = 2. 061 ） were significantly associated with influenza infection in logistic regression analysis. The combination of cough and nasal symptoms/sore throat had the positive predictive value of 41.3 %, negative predictive value of 78.4 96, sensitivity of 58.8 96 and specificity of 64.196 for predicting the influenza infection among children. Conclusions A better case definition of influenza like illness in children for influenza surveillance is： fever （temperature ≥38 ℃ ）, cough accompanied by nasal symptoms or sore throat.

关 键 词：流感 儿童 回归分析 

分 类 号：R181.23[医药卫生—流行病学]