北京市海淀医院2017至2019年流感样病病原学监测及抗病毒治疗  

Analysis on the current situation of pathogen monitoring and antiviral treatment of influenza-like cases in Beijing Haidian Hospital from 2017 to 2019

作　　者：李珺[1] 滕珈瑄 田国保[1] 夏春花[3] 王笑灵 董建平[1] Li Jun;Teng Jiaxuan;Tian Guobao;Xia Chunhua;Wang Xiaoling;Dong Jianping(Department of Infectious Diseases,Beijing Haidian Section of Third Hospoital,Peking University,Beijing Haidian Hospital,Beijing 100080,China;Department of Pharmacy,Beijing Haidian Section of Third Hospoital,Peking University,Beijing Haidian Hospital,Beijing 100080,China;Department of Diseases of Prevention and Control,Beijing Haidian Section of Third Hospoital,Peking University,Beijing Haidian Hospital,Beijing 100080,China)

机构地区：[1]北京市海淀医院(北京大学第三医院海淀院区)感染性疾病科,北京100080 [2]北京市海淀医院(北京大学第三医院海淀院区)药剂科,北京100080 [3]北京市海淀医院(北京大学第三医院海淀院区)疾控科,北京100080

出　　处：《中华实验和临床感染病杂志（电子版）》2020年第3期218-223,共6页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

摘　　要：目的分析北京市海淀医院2017至2019年流感季节(每年12月至次年2月)流感样病的流行特征及抗病毒药物使用,为完善流感样病防治策略提供依据。方法回顾性收集北京市海淀医院发热门诊、急诊及儿科急诊2017至2019年报告的流感样病患者信息和实验室病原监测结果,采用描述流行病学方法,对流感样病的流行强度、病原构成、抗病毒药物使用进行分析;并分析不同年度,不同年龄组,流感样病例上报情况和抗病毒药物使用。结果2017至2018年度接受抗病毒治疗的患者中流感病毒抗原阳性占78.6%,而2018至2019年度该比例下降至52.4%。2017至2018年度25岁以上年龄组流感病毒抗原阳性占比较其他年龄组较低,差异有统计学意义(χ^2=254.398、P<0.001),2018至2019年度60岁以上年龄组流感病毒抗原阳性占比较低(χ^2=668.543、P<0.001),无论是2017至2018年度还是2018至2019年度,12月份流感病毒抗原阳性占比均较高(χ^2=232.397、212.497,P均<0.001)。流感病毒抗原分型:2017至2018年度以乙型流感为主,而2018至2019年度以甲型流感为主(χ^2=74.545、187.847,P均<0.001)。流感样病例接受抗病毒治疗的比例由2017至2018年度的38.9%上升至2018至2019年度的64.6%;<4岁及>60岁两个年龄组患者抗病毒治疗比例偏低,2017至2018年度两组人群抗病毒治疗率分别为22.2%(937/4221)和30.1%(575/1908)(χ^2=1210.409、P<0.001),2018至2019年度,两组人群抗病毒治疗率分别为40.0%(1185/2964)和46.1%(767/1665),差异有统计学意义(χ^2=1850.166、P<0.001)。结论本院12月份流感病毒抗原阳性占比较高,2017至2018年度以乙型流感为主,而2018至2019年度以甲型流感为主。<4岁的婴幼儿及>60岁的老年人流感样病例抗病毒治疗占比仍然偏低,有待进一步提高。Objective To analyze the epidemic characteristics of influenza-like cases,the composition and changes of pathogen spectrum and the use of antiviral drugs in Beijing Haidian Hospital during influenza season(December to February of each year)from 2017 to 2019,and to provide a basis for the prevention and treatment strategy of influenza-like cases.Methods The information and laboratory pathogen monitoring results of influenza-like cases reported in the fever outpatient clinic,emergency department and pediatric emergency department of Beijing Haidian Hospital from 2017 to 2019 were collected,retrospectively.The epidemic intensity,pathogen composition and antiviral use of influenza-like cases were analyzed by descriptive epidemiological method.The reports of influenza-like cases and the use of antiviral drugs in different years and age groups were compared and analyzed,respectively.Results In 2017-2018,78.6%of patients receiving antiviral treatment were positive for influenza virus antigen,while in 2018-2019,the proportion decreased to 52.4%.In 2017-2018,compared with other age group,the proportion of positive influenza virus antigens in the group>25 years old was relatively low,with significant difference(χ^2=254.398,P<0.001),and the proportions of positive influenza virus antigens in the group>60 years old was significantly low in 2018-2019,with significant difference(χ^2=668.543,P<0.001).In both 2017-2018 and 2018-2019,the proportions of positive influenza virus antigens in December was significantly high,with significant differences(χ^2=232.397,P<0.001;χ^2=212.497,P<0.001).Influenza B were the dominant antigen type in 2017-2018,and influenza A was the dominant antigen type in 2018-2019,with significant differences(χ^2=74.545,P<0.001;χ^2=187.847,P<0.001).The proportion of influenza-like cases receiving antiviral therapy increased from 38.9%in 2017-2018 to 64.6%in 2018-2019.The proportion of antiviral therapy in age groups of<4 years old and>60 years old were low,and the antiviral therapy rates in the two grou

关 键 词：流行性感冒 病原学监测 抗病毒治疗 

分 类 号：R511.7[医药卫生—内科学]