2013-2017年陕西省宝鸡市脑炎脑膜炎症候群监测系统的构建及应用分析  

Establishment and application of acute meningitis and encephalitis syndromes surveillance system in Baoji,Shaanxi,2013–2017

作　　者：张晓宇[1] 郭彦萍[2] 杜红忠[1] Zhang Xiaoyu;Guo Yanping;Du Hongzhong(Baoji Prefectural Center for Disease Control and Prevention,Baoji 721006,Shaanxi,China;Baoji Maternal and Child Health Care Hospital,721001,Shaanxi,China)

机构地区：[1]宝鸡市疾病预防控制中心,陕西宝鸡721006 [2]宝鸡市妇幼保健院,陕西宝鸡721001

出　　处：《疾病监测》2018年第7期564-568,共5页Disease Surveillance

摘　　要：目的分析2013—2017年陕西省宝鸡市急性脑炎脑膜炎症候群(AMES)监测病例的流行特征及病原谱构成,为指导急性脑炎脑膜炎的诊断提供依据。方法制定宝鸡市AMES监测方案,按照病例定义和监测方案要求开展监测,采用描述流行病学方法分析报告的AMES病例。结果共报告AMES病例1 282例,报告病例逐年递增。病毒性AMES病例最多(66.38%);城市占18.25%,农村占81.75%,城乡比例为1∶4.48;病毒性脑炎脑膜炎病例发病高峰在7—10月(51.95%),细菌性脑膜炎分布在12月至次年3月和6—9月(38.18%和33.64%);<10岁病例占65.29%,发病以散居儿童为主(42.67%);流行性乙型脑炎(乙脑)病毒Ig M抗体阳性率为7.72%,其中有47例(47.47%)从非乙脑诊断的AMES病例中检出;脑膜炎奈瑟菌(Nm)、肺炎链球菌(Spn)、流感嗜血杆菌(Hi)的阳性率分别为2.42%、0.62%、2.50%。结论宝鸡市对乙脑病毒引起的脑炎,Nm、Spn和Hib引起的脑膜炎存在一定的误诊和漏诊,AMES监测可指导临床诊治,应继续加强监测。Objective To analyze the epidemiological characteristics and the pathogen spectrum of acute meningitis and encephalitis syndromes（AMES） in Baoji, Shaanxi from 2013 to 2017. Methods We developed local AMES surveillance protocol and conducted surveillance in Baoji according to the surveillance protocol and case definition. Descriptive epidemiological analysis was conducted by using the incidence data of AMES in Baoji. Results A total of 1 282 AMES cases were reported during 2013–2017, and the reported cases increased year by year. Among these cases, viral AMES accounted for66.38%; AMES cases in urban area and in rural area accounted for 18.25% and 81.75% respectively. The urban-rural ratio of the cases was 1∶4.48. The incidence peak of viral AMES occurred from July to October（51.95%）, and the incidence of bacterial meningitis peaked during December-March and June-September, accounting for 38.18% and 33.64% respectively;Most cases were children aged 〈10 yeas（65.29%）, and the cases mainly occurred in children outside child care settings（42.67%）. The positive rate of Ig M against Japanese encephalitis virus was 7.72%, and Japanese encephalitis virus was detected from 47 other AMES cases（47.47%）. The detection rates of Neisseria meningitides, Streptococcus pneumoniae and Haemophilus influenza type b were 2.42%, 0.62%, and 2.50% respectively. Conclusion Due to the possible misdiagnoses and missed diagnoses of encephalitis caused by Japanese encephalitis virus and meningitis caused by N. meningitides,S. pneumoniae and H. influenza type b, AMES surveillance can improve the performance of clinical diagnoses of the diseases.It is still necessary to further strengthen AMES surveillance in Baoji.

关 键 词：脑炎脑膜炎症候群 监测 系统构建 应用分析 

分 类 号：R512.3[医药卫生—内科学]