2011-2019年四川省重症手足口病流行特征及其影响因素研究  

Epidemiology and Influencing Factors of Severe Hand Foot Mouth Disease in Sichuan Province From 2011 to 2019

作　　者：李羚[1] 刘润友[1] 张云娜[1] 蔺鸿[1] 许军红[1] 彭艳秋 李蔚 杨长虹[1] LI Ling;LIU Runyou;ZHANG Yunna;LIN Hong;XU Junhong;PENG Yanqiu;LI Wei;YANG Changhong(Sichuan Center for Disease Control and Prevention,Chengdu 610041,Sichuan Province,China)

机构地区：[1]四川省疾病预防控制中心,成都610041

出　　处：《预防医学情报杂志》2020年第12期1535-1542,共8页Journal of Preventive Medicine Information

基　　金：National Institutes of Health(项目编号:R01AI125842);四川省疾病预防控制中心课题(项目编号:ZX201914)。

摘　　要：目的分析四川省重症手足口病的流行特征和病原学特点,初步探索重症病例的影响因素。方法采用描述性流行病学方法,对四川省2011-2019年间报告的重症手足口病例进行分析。地图采用Arcgis 10.2软件进行制作。采用R 3.6.1统计软件进行重症手足口病影响因素Logistic回归分析。结果2011-2019年四川省重症手足口病发病率为0.61/10万,重症比例为0.64%。发病主要高峰时间为4-8月;重症手足口病发病强度在逐渐减小,病例主要集中在成都市、眉山市、绵阳市等交通发达、人口密集地区;以5岁以下人群为主,占全部重症的96.36%,散居儿童高于幼托儿童,男性多于女性。实验室诊断病例数不断升高,其他肠道病毒检出率最高,达到54.99%。感染EV 71的病例发展为重症的风险最高。EV 71病例多出现在4-8月。EV 71在3~5岁年龄组检出率最高,其他肠道病毒在1~2岁年龄组检出率最高。低年龄、EV 71感染、诊断时病程较短与重症手足口病发病风险增加相关。结论四川省重症手足口病发病有所减少,但病原体在不断变化,其他肠道病毒引起重症比例有所增加,应引起重视。年龄、病毒分型、诊断时病程是重症手足口病的影响因素,进一步探索重症手足口病发病的其他影响因素,鼓励重点人群接种EV 71疫苗,从而控制并减少重症手足口病的发生。Objective To study the epidemiology and etiologic features of severe Hand-foot-mouth Disease(HFMD)in Sichuan,and to explore influencing factors of severe cases.Methods Description epidemiology analysis was conducted to analyze the data in 2011-2019.We used Arcgis 10.2 to draw maps.R3.6.1 was used to study Logistic regression about influencing factors.Results The morbidity of severe HFMD in 2011-2019 was 0.61/105.The proportion of severe HFMD was 0.64%.The main peak mouths were April-August.The intensity of incidence of severe HFMD decreased gradually.Cases were mainly concentrated in Chengdu,Meishan,Mianyang and other areas with developed transportation and dense population.The patients were mainly children under 5 years old which was accounted for 96.36%of all severe cases.The morbidity of scattered children was higher than that of childcare children.The number of male patients were more than female.The number of laboratory diagnosed cases was increasing,and the detection rate of other enteroviruses was the highest(54.99%).The patients infected with EV71 had the highest risk of developing into severe cases.The cases infected with EV71 mainly were in April-August.The detection rate of EV71 was highest in the age group of 3-5 years old,while the detection rate of other enteroviruses was highest in the age group of 1-2 years old.Low age,EV71 infection and shorter duration at the time of diagnosis increased the risks of severe HFMD.Conclusion The incidence of severe HFMD has decreased in Sichuan province,but the pathogen is changing constantly.We should pay attention to that the rate of severe HFMD caused by other enteroviruses is increasing.Age,virus type and duration at the time of diagnosis are the influencing factors of severe HFMD.Further exploring the influencing factors of severe HFMD and encouraging EV71 vaccination of children are needed so as to control and reduce the morbidity of severe HFMD.

关 键 词：重症手足口病 流行特征 病原学 影响因素 

分 类 号：R181[医药卫生—流行病学]