2016~2019年成都市某哨点监测医院确诊流行性感冒住院患儿流行病学及不同亚型临床特点分析  

An analysis of epidemiology and clinical characteristics of inpatients with different subtypes of influenza confirmed at a surveillance outpost hospital in Chengdu from 2016 to 2019

作　　者：刘艳[1] 刘丽[1] 向丽佳[2] 周建翔 徐小评[1] LIU Yan;LIU Li;XIANG Li-Jia;ZHOU Jian-xiang;XU Xiao-ping(Department of Paediatrics,Chengdu Second People's Hospital,Chengdu 610017,China;Department of Infection Control,Chengdu Second People's Hospital,Chengdu 610017,China;Operation Section of Finance Department,Chengdu Second People's Hospital,Chengdu 610017,China)

机构地区：[1]成都市第二人民医院儿科,四川成都610017 [2]成都市第二人民医院感染管理科,四川成都610017 [3]成都市第二人民医院财务部运营科,四川成都610017

出　　处：《实用医院临床杂志》2020年第5期111-114,共4页Practical Journal of Clinical Medicine

摘　　要：目的分析哨点监测医院确诊的流行性感冒(流感)住院患儿的流行病学特征,比较不同亚型流感住院患儿的临床特征。方法回顾性收集2016年1月1日至2019年12月31日成都市第二人民医院的流感儿童监测数据,对确诊流感住院患儿的一般人口学资料、流行病学资料及不同亚型的临床特征、实验室指标、预后资料等进行分析。结果有269例经实验室核酸检测阳性,阳性率28.11%,4种主要亚型均有检出,甲型H1N190例(32.85%)、甲型H3N289例(32.48%)、乙型BV 54例(19.71%)和乙型BY 36例(13.14%)。发病年龄高峰主要集中在1~10岁人群,占90.71%。流行曲线看发病高峰为11月至次年的1月,最高峰出现在12月,确诊患儿达164例,占全部确诊病例的60.97%。以学生为主109例(39.78%)。不同亚型确诊流感患者在性别构成、临床表现为咽痛、流涕、腹泻、白细胞计数升高、细菌/支原体/衣原体感染阳性、肾脏损害、治疗结局之间比较,差异均有统计学意义(P<0.05)。不同亚型流感患儿的人均住院总费用比较差异有统计学意义(H=10.702,P=0.005),甲型H3N2患儿的住院总费用最高,乙型BV患儿的住院总费用最低。结论1~10岁为儿童流感高发人群,流行曲线为冬季单峰流行。甲型流感对患儿造成的临床结局更为严重,其中又以甲型H1N1亚型更甚。Objective To analyze the epidemiological characteristics of influenza inpatients in a sentinel surveillance hospital,and compare the clinical characteristics of different subtypes of influenza inpatients.Methods The surveillance data of influenza in our hospital From January 1,2016 to December 31,2019 in Chengdu were collected retrospectively,and the general demographic data,epidemiological data,clinical characteristics of different subtypes,laboratory indicators,and prognosis data of hospitalized influenza patients were analyzed.Results There were 269 positive cases confirmed by laboratory nucleic acid test.The positive rate was 28.11%.Four major subtypes were detected,in which 90 cases were type A H1N1(32.85%),89 cases were type A H3N2(32.48%),54 patients were type B BV(19.71%)and 36 cases were type B BY(13.14%).The peak age of onset was mainly concentrated in the population of 1 to 10 years old,accounting for 90.71%of the total.The epidemic curve showed that the peak of incidence was from November to January of the following year,and the highest peak appears in December with 164 diagnosed children,accounting for 60.97%of all confirmed cases.There were 109 student cases(39.78%).There were significant differences in gender composition,clinical manifestations such as sore throat,runny nose,diarrhea,increased white blood cell count,positive bacterial/mycoplasma/chlamydia infection,kidney damage,and treatment outcomes in patients with different subtype of influenza(P<0.05).There was a statistical difference between the total hospitalization costs of children with different subtypes of influenza(H=10.702,P=0.005).The total hospitalization cost of children with type A H3N2 was the highest while the total hospitalization cost of children with type B BV was the lowest.Conclusion Children with 1 to 10 years old have high incidence of influenza.The epidemic curve is unimodal in winter.The subtype A H1N1 causes more serious clinical outcomes in children.

关 键 词：流行性感冒 流行病学 临床特征 监测 

分 类 号：R511.7[医药卫生—内科学]