石家庄市肺炎链球菌脑膜炎病例特征分析  

Cases analysis of streptococcus pneumonia meningitis in children in Shijiazhuang

作　　者：郭建花[1] 张世勇[1] 周吉坤[1] 李静[2] 孙印旗[2] 尹遵栋[3] 

机构地区：[1]石家庄市疾病预防控制中心流行病防治所,河北石家庄050011 [2]河北省疾病预防控制中心 [3]中国疾病预防控制中心免疫规划中心

出　　处：《现代预防医学》2013年第17期3286-3288,3292,共4页Modern Preventive Medicine

基　　金：WHO/卫生部流行性脑脊髓膜炎和流行性乙型脑炎等疾病监测合作项目(2007-2009);卫生部急性脑炎脑膜炎症状监测合作项目(2010-2012)

摘　　要：目的分析肺炎链球菌脑膜炎病例的流行特征,为其科学防控提供依据。方法 2008年5月～2012年5月,在5个县(市)、区的6所医院中主动开展脑炎、脑膜炎症状监测,对其血、脑脊液标本进行肺炎链球菌细菌培养和RT-PCR检测。结果在1632例监测病例中检出27例肺炎链球菌脑膜炎病例,年龄中位数为6.01岁(3月龄～43岁),15岁及以下儿童发病率为1.36/10万,5～岁儿童年发病率最高,为2.82/10万。一年四季均有病例发生,但夏季较多。2例有肺炎链球菌疫苗接种史,标本采集前1周均使用了抗生素。患者发病至最终就诊时间间隔的长短与其同时具有的临床症状体征数量的多少呈线性正相关(rs=0.717,P=0.000)。临床症状、实验室检测结果趋向不典型。结论肺炎链球菌脑膜炎发病情况高于流感嗜血杆菌脑膜炎和流行性脑脊髓膜炎,以儿童为主。OBJECTIVE To analyse the epidemic character, clinical feature and laboratorial result of meningitis caused by streptococcus pneumonia （Sp）. METHODS Acute encephalitis and meningitis were actively monitored by the perspective ob- servational study from May in 2008 to May in 2012. There were one children＇s hospital, three provincial general hospitals and two rural general county hospitals in five counties, districts involved of the active surveillance system randomly. Bacterial cul- ture and RT-PCR were used to detect the agent by blood and cerebrospinal fluid （CSF）. RESULTS There were 27 cases with Sp. The median age was 6.01 （range, 3 months-43 years）. The annual average incidence rate of children 〈 15 years was 1.36/lakh in Shijiazhuang. The incidence rate of Sp among children t〉5 years and 〈 10 years was highest, the rate of 2.82/ Iakh in Shijiazhuang. These cases were mainly from village and without vaccination. The disease occurred all the year round, with an increased incidence in summer. There was linear positive correlation between the amount of clinical feature and the time interval from the illness onset to admission （rs = 0.717, P = 0.000）. The clinical symptoms and the result of laboratory were nonspecific respectively. CONCLUSION Incidence of Sp meningitis is higher than that of haemophilus influenza type b meningitis and meningococal meningitis. Most of patients with Sp meningitis are children.

关 键 词：肺炎链球菌 脑膜炎症状监测 流行特征 临床特点 实验室检测 

分 类 号：R515.2[医药卫生—内科学]