2012年上海地区麻疹住院儿童临床及流行病学特征分析  

Analysis on clinical and epidemiological characteristics of measles in hospitalized children in Shanghai in 2012

作　　者：韩书珍[1] 叶颖子[1] 曹凌峰[2] 徐锦[2] 浦东波[1] 俞蕙[1] 

机构地区：[1]复旦大学附属儿科医院感染传染科,上海201102 [2]复旦大学附属儿科医院小儿感染传染病实验室,上海201102

出　　处：《中华儿科杂志》2015年第8期605-609,共5页Chinese Journal of Pediatrics

摘　　要：目的分析2012年复旦大学附属儿科医院182例麻疹住院患儿的流行病学特征，探讨影响麻疹发病的主要因素，了解麻疹病毒基因分型，为进一步控制麻疹的流行提供科学的决策依据。方法回顾性分析2012年1月1日至12月31日复旦大学附属儿科医院确诊并住院治疗的182例麻疹患儿的性别、年龄、流行趋势和发病季节、麻疹疫苗的接种史、接触史等流行病学特征和临床表现、辅助检查结果，并应用RT—PCR方法对随机采样的麻疹患儿的痰液标本进行麻疹病毒检测，PCR扩增阳性的片段进一步行麻疹基因测序分型。结果（1）临床流行病学资料：182例患者中，男125例，女57例，男：女=2．2：1；年龄3～89个月，〈9月龄127例（69．8％）；4至8月份为麻疹高发季节，4、5月份为发病最高峰；182例麻疹患儿中有麻疹疫苗接种史者11例（6．0％），其中5例接种疫苗2周内发病，无接种史者167例（91．8％），接种史不详者4例（2．2％）。流动人口（144例）中适于麻疹疫苗接种者的麻疹疫苗接种率8．5％（6／71），与本市户籍人口中适于接种年龄的患儿接种率（29．4％，5／17）比较，差异有统计学意义（χ2=8．11，P=0．004）。有明确麻疹接触史者24例（13．2％），接触史不详者153例（84．1％），否认接触史5例（2．7％）。（2）临床表现：182例均有发热及皮疹（100％），体温高于39℃者145例（79．7％），热程2—38d；典型麻疹165例（90．7％），不典型麻疹17例，轻型麻疹14例，重型麻疹2例，可疑异型麻疹1例。（3）常见并发症：肺炎96例（52．8％），喉炎80例（44．0％），支气管炎38例（20．9％），肝功能损害15例（8．2％），心肌损害11例（6．0％），高热惊厥3例（1．6％）。96例麻疹肺炎患儿中92例进行痰病原学检测，细菌培养阳性者38例（41％），最常见的病原分别为肺�Objective To investigate the main factors that influence measles morbidity and the genotype of measles virus, so as to provide evidence for scientific decision making to further control the prevalence of measles. Method A retrospective analysis included 182 children in Children＇s Hospital of Fudan University, diagnosed with measles from January 1, 2012 to December 31. The clinical and epidemiological characteristics, including the gender, age, the incidence of seasonal trends, measles vaccine vaccination history, contact history and other clinical manifestations, laboratory test results, and so on were analyzed. And the reverse transcription PCR （RT-PCR） was adopted to detect sputum specimens from suspected patients with measles ,who were selected randomly, the sequence of the part of the PCR productswas analyzed. Result （ 1 ） Clinical and epidemiological data： Totally were 182 children with measles （ 125 males ,57 females） were enrolled into this study. The age of the patients ranged from 3 months to 89 months, 127 cases were younger than 9 months （69. 8% ）. The prevalence season was from April to August, while the peak month was April and May （22.5%, 23.1%）. Among 182 hospitalized children, only 11 cases underwent measles vaccination （6. 0% ）, and among them 5 cases were within 2 weeks before disease onset. A total of 167 cases （91.8%） had not been vaccinated, most of whom were immigrants, and the measles vaccination history of the remaining 4 cases were unknown. There was a positive correlation between the measles vaccination ratio in children of the floating population （8.45% ,6/71 ） and the settled children （29.4 % ,5/17, χ2 = 8.11, P = 0. 004）. In total, 24 cases （ 13.2% ） had definite measles exposure history, with 153 cases （84. 1% ） of unknown origin,5 cases （2. 7% ） without any history of contact. （2） Clinical manifestations： All the 182 patients had fever （100%） and obvious rashes （100%） , among them 145 cases had body temperature highe

关 键 词：麻疹 儿童 基因型 流行病学 

分 类 号：R725.1[医药卫生—儿科]