苏州地区2011-2017年5岁以下儿童流感相关严重急性呼吸道感染临床症状和影响因素研究  

Study on clinical symptoms and influencing factors of influenza-associated severe acute respiratory illness in children younger than 5 years old in Suzhou of China,2011-2017

作　　者：张婉青 陈立凌[2] 成芳芳[3] 代子瑞 冯爽 张钧[2] 田健美[3] 张涛[1] 赵根明[1] Zhang Wanqing;Chen Liling;Cheng Fangfang;Dai Zirui;Feng Shuang;Zhang Jun;Tian Jianmei;Zhang Tao;Zhao Genming(Department of Epidemiology,School of Public Health,Fudan University/Key Laboratory of Public Health Safety,Ministry of Education,Fudan University,Shanghai 200032,China;Department of Infectious Disease Prevention and Control,Suzhou Center for Disease Control and Prevention,Suzhou 215004,China;Department of Infection,Children's Hospital of Soochow University,Suzhou 215003,China)

机构地区：[1]复旦大学公共卫生学院流行病学教研室公共卫生安全教育部重点实验室,上海200032 [2]苏州市疾病预防控制中心传染病预防控制科,215004 [3]苏州大学附属儿童医院感染科,215003

出　　处：《中华流行病学杂志》2021年第6期1044-1049,共6页Chinese Journal of Epidemiology

基　　金：中美新发和再发传染病合作项目(5U2GGH000018);上海市公共卫生体系建设三年行动计划(2020-2022)重点学科建设(GWV-10.1-XK16)。

摘　　要：目的探讨江苏省苏州地区<5岁儿童流感相关严重急性呼吸道感染(SARI)的影响因素,为完善儿童流感防控策略提供证据支持。方法基于2011年4月至2017年3月在苏州大学附属儿童医院持续开展的前瞻性流感监测的相关数据,χ^(2)检验比较流感相关流感样疾病(ILI)和流感相关SARI之间的临床特征,非条件logistic回归分析流感相关SARI的影响因素。结果共收集流感相关ILI 786例,流感相关SARI 413例。咳嗽、流涕、气促、哮喘/喘息等临床症状在流感相关SARI中出现的比例显著高于流感相关ILI(P<0.01)。单因素和多因素logistic回归分析结果显示,年龄<6月龄(OR=3.6)、6~23月龄(aOR=2.5)、3个月内呼吸道感染史(aOR=4.5)、慢性肺部疾病史(OR=3.4)、发热热峰39.0~39.9℃(aOR=2.4)、≥40℃(aOR=6.0)、甲型(H1N1)(aOR=2.3)和甲型(H3N2)(aOR=1.9)流感病毒感染是流感相关SARI的影响因素。结论年龄<2岁、有慢性肺部疾病史、有3个月内呼吸系统感染史以及发热热峰≥39.0℃的儿童应尽早就医,或每年接种流感疫苗,以减少流感相关严重结局的发生。Objective To study the influencing factors of influenza-associated severe acute respiratory illness(SARI)in children younger than 5 years of old in Suzhou,and to provide evidence to support the improvement of prevention and control strategies for influenza in children.Methods We conducted a prospective influenza surveillance for hospitalized SARI and outpatient influenza-like illness(ILI)at Children′s Hospital of Soochow University from April 2011 to March 2017.We compared the clinical and other characteristics of influenza-positive patients with SARI to those with ILI to find the differences and to identify influencing factors of influenza-associated SARI,usingχ^(2) test and unconditional logistic regression.Results We found 786 cases of influenza-associated ILI and 413 cases of influenza-associated SARI during the study period.Cough,runny nose,shortness of breath,asthma or wheezing were more common in influenza-associated SARI than in influenza-associated ILI(P<0.01).Univariate and multivariate logistic regression showed that the influencing factors which significantly associated with increased risk of influenza-associated SARI were as follows:younger age(<6 months OR=3.6,6-23 months aOR=2.5),respiratory infection history within 3 months(aOR=4.5),chronic lung disease history(OR=3.4),fever above 39.0℃(39.0-39.9℃aOR=2.4,≥40.0℃aOR=6.0),and the presence of A/H1N1(aOR=2.3),A/H3N2(aOR=1.9).Conclusion Children younger than 2 years old,with a history of chronic lung disease,a history of respiratory infection within 3 months,or with a fever peak above 39.0℃should seek medical advice as soon as possible or receive annual influenza vaccination to reduce the incidence of influenza-associated serious outcomes.

关 键 词：儿童 流感 住院 影响因素 

分 类 号：R725.1[医药卫生—儿科] R725.6[医药卫生—临床医学]