发热门诊疾病谱及流行性感冒样病例监测意义研究  

Disease spectrum of fever patients and significance of influenza-like illness monitoring

作　　者：王伟[1] 李晓光[1] 胥婕[1] 

机构地区：[1]北京大学第三医院感染疾病科,北京100191

出　　处：《中国实用内科杂志》2015年第1期60-62,共3页Chinese Journal of Practical Internal Medicine

基　　金：国家高技术研究发展计划资助(2008AA02Z416)

摘　　要：目的分析三级综合性医院发热门诊就诊患者的疾病谱、流行病学特征,探讨流行性感冒样病例(流感样病例)监测在流感大流行中的预警作用。方法采用回顾性分析方法 ,对2009年4月至2010年4月间就诊于北京大学第三医院发热门诊的41196例发热患者,做疾病谱和流行病学特征分析及流感样病例监测人数、呼吸系统疾病病例人数与发热门诊就诊人数相关性分析。结果发热病例的疾病谱中,以呼吸系统感染患者最多,36208例(87.9%),其次是消化系统感染2013例(4.9%),泌尿系统感染374例(0.9%),其他部位感染1026例(2.5%),混合感染1142例(2.8%),非感染性疾病433例(1.0%);其中除流感外其他传染病107例,流感样病例15 664例(38.0%),其时间趋势与发热门诊每月就诊人数呈高度正相关(r=0.88,P<0.01)。结论综合医院发热门诊发热病例的疾病谱比较复杂,哨点医院流感样病例监测有助于疾病预防控制中心预判流感流行趋势,为流感防控提供一线临床资料。Objective To analyze the disease＇ spectrum of fever patients and the epidemiologic features and to investigate the role of influenza-like cases in early warning monitoring during a pandemic influenza year. Methods A total of 41196 patients were collected from to the fever clinic of Infectious Diseases Department, Peking University Third Hospital, between April 2009 to April 2010. A retrospective study was performed to analyze the disease spectrum and epidemiologic features; correlation analysis was done to analyze influenza-like cases, cases of respiratory disease and monthly visits in fever clinic. Results In the disease＇s spectrum of fever patients, the first leading cause was respiratory diseases（36208 cases）（87.9%）, followed by digestive tract infection diseases（2013 cases）（4.9%）, and other causes included urinary system infection（374 cases）（0.9%）, infection of other sites（1026 cases）（2.5%）, poly-infection diseases（1142 cases）（2.8%）, and noninfectious diseases（433 cases）（1%）. Among total patients there were107 cases of infectious diseases（exclusion of influenza） and 15664 cases of influenza-like illness（38%）. There exist a positive correlation between the monitoring of influenza-like illness and monthly visits in fever clinic（r=0.88, P〈0.01）. Conclusion The spectrum of fever is complex in fever clinic of comprehensive hospitals, and monitoring of influenza-like cases in sentinel hospitals help the Centers for Disease Control and Prevention to predict the tendency of influenza and provide clinical data for the prevention and control of influenza.

关 键 词：发热 疾病谱 流行性感冒 

分 类 号：R511.7[医药卫生—内科学]