2004至2017年北京地区儿童流行性感冒样病例中甲型流行性感冒的流行特征  

Epidemiological features of prevalent influenza A viruses in children with influenza-like illness during the 2004-2017 season in Beijing

作　　者：王芳[1] 钱渊[1] 邓洁[1] 孙宇[1] 赵林清[1] 田润[1] 朱汝南[1] Wang Fang;Qian Yuan;Deng Jie;Sun Yu;Zhao Linqing;Tian Run;Zhu Runan(Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in Children, Capital Institute of Pediatrics, Beijing 100020, China)

机构地区：[1]首都儿科研究所病毒研究室 儿童病毒病病原学北京市重点实验室,100020

出　　处：《中华儿科杂志》2018年第6期429-434,共6页Chinese Journal of Pediatrics

基　　金：北京市科技计划（Z111107056811041）

摘　　要：目的分析2004—2017年连续13个监测年度北京地区儿童中甲型流行性感冒（流感）的流行特征。方法重复横断面研究，2004年9月至2017年8月每周采集首都儿科研究所附属儿童医院门、急诊流感样病例患儿的咽拭子标本，采用传代狗肾细胞（MDCK细胞）行流感病毒分离，并用特异性血清对分离到的流感病毒进行血凝抑制试验鉴定型别。组间差异采用t检验或χ2检验，对13个监测年度中不同型别的甲型流感的流行特征及不同年龄组患儿感染特征进行分析，并与同期乙型流感进行比较。结果2004—2017年13个监测年度共采集流感样病例咽拭子标本10 984份，共检测到甲型流感病毒1 052株，总阳性率为9.6%，高于乙型流感（6.7%，741/10 984），包括70株季节性H1N1、302株甲型H1N1和680株H3N2阳性标本。所有甲型流感病毒阳性患儿年龄为（4.2±2.9）岁，男性患儿占55.5%（584/1 052）；季节性H1N1、甲型H1N1和H3N2阳性患儿年龄分别为（4.6±2.1）、（4.3±3.1）和（4.2±2.9）岁，各亚型阳性患儿的年龄差异均无统计学意义（季节性H1N1比H3N2：t=1.139，P=0.255；甲型H1N1比H3N2：t=0.631，P=0.528；季节性H1N1比甲型H1N1：t=0.720，P=0.472）；而乙型流感阳性患儿平均年龄[（5.2±2.7）岁]大于甲型流感患儿（t=7.120，P=0.000）；各年龄组甲型和乙型感染率差异均有统计学意义（P均〈0.05）；甲型H1N1（除0～0.5岁年龄组）和H3N2各年龄组患儿的感染率随着年龄增长而升高；〉0.5～12.0岁各年龄组儿童感染H3N2的阳性率均高于季节性H1N1和甲型H1N1（P均〈0.05）。当甲型流感阳性率高于乙型时，其流行高峰均出现在乙型高峰之前，反之亦然；季节性H1N1在2009年后未检出；2009年之后甲型H1N1成为季节性流行株，阳性率高于原季节性H1N1，呈现连续出现两个流行高峰后出现一个流行低谷的规律；H3N2每年均有一个流行峰，ObjectiveTo analyze and compare the epidemiological features of prevalent influenza A viruses in children in Beijing during 13 consecutive surveillance seasons from 2004 to 2017.MethodsThis was a repeated cross section study. Throat swabs were collected weekly from children with influenza-like illnesses （ILI） who presented to the outpatient/emergency department of Children＇s Hospital, Capital Institute of Pediatrics during the period from September, 2004 to August, 2017. All of the specimens were inoculated into Madin Darby canine kidney （MDCK） cells to isolate influenza viruses followed by identifying different types of influenza viruses with reference antisera by hemagglutination-inhibition assay. Descriptive statistics, t test and chi-square test were used to analyze the characteristics of prevalent influenza and characteristics of children infected with different types of influenza viruses.ResultsOut of 10 984 specimens from ILI tested for influenza viruses, 1 052 （9.6%） were positive for influenza A viruses, and the positive rate was higher than that of influenza B viruses （6.7%, 741/10 984）. Out of 1 052 cases positive for influenza A viruses, 70 cases of seasonal H1N1, 302 cases of 2 009 pandemic H1N1 and 680 cases of H3N2 were identified. The mean age of children with influenza A was （4.2±2.9） years, in whom 55.5% （584/1 052） were male. The mean age of children infected with seasonal H1N1, 2009 pandemic H1N1 and H3N2 was （4.6±2.1） , （4.3±3.1） and （4.2±2.9） years, respectively. There was no significant difference in the mean age among children infected with different subtypes of influenza A viruses （seasonal H1N1 vs. H3N2： t=1.139, P=0.255; 2009 pandemic H1N1 vs. H3N2： t=0.631, P=0.528; seasonal H1N1 vs. 2009 pandemic H1N1： t=0.720, P=0.472）, while the mean age of children with influenza B was higher than that of the patients with influenza A （（5.2±2.7） vs. （4.2±2.9） years, t=7.120, P=0.000）. The infection rate of influenza A in children wit

关 键 词：流感病毒A型 流行病学研究特征(主题) 儿童 病毒分离 

分 类 号：R181.3[医药卫生—流行病学] R725.1[医药卫生—公共卫生与预防医学]