757例麻疹患儿流行病学和临床特征  

Epidemiology and clinical characteristics of 757 children with measles

作　　者：苗敏 王彩英 何树新 庞琳 Miao Min;Wang Caiying;He Shuxin;Pang Lin(Department of Pediatrics,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China)

机构地区：[1]首都医科大学附属北京地坛医院儿科,北京100015

出　　处：《中华实验和临床感染病杂志（电子版）》2022年第4期261-267,共7页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

基　　金：北京市医院管理局“扬帆”重点医学发展计划(No.ZYLX201602)。

摘　　要：目的分析儿童麻疹患者住院病例的流行病学和临床特征,为麻疹防控及其诊治提供依据。方法回顾性收集首都医科大学附属北京地坛医院儿科2009年3月至2019年7月收治住院的757例麻疹患儿的临床资料,包括发病时间、性别、年龄、麻疹疫苗接种史、麻疹患者接触史、临床表现、并发症、辅助检查、治疗及转归。采用描述性流行病学方法对757例患儿临床资料进行统计,正态分布计量资料采用x±s表示,偏态分布计量资料则采用中位数(四分位数)[M(P25,P75)]表示;计数资料以[例(%)]描述。结果757例麻疹患儿多发病于3~5月份(450例、59.4%),其中男性患儿505例(66.7%);女性患儿252例(33.3%);年龄为8.7(6.7,12)个月,<1岁患儿占71.7%(543/757);未接种疫苗患儿653例(86.3%)。入组患儿临床表现以皮疹[100%(757/757)]、发热[99.5%(753/757)]、咳嗽[72.0%(545/757)]以及麻疹黏膜斑(Koplik斑)[58.4%(442/757)]多见,并发症以肺炎最为常见[77.5%(587/757)]。16例(2.0%)患儿出现肺气漏:纵隔气肿及皮下气肿13例(81.3%),其中合并气胸7例;单独气胸3例(18.7%)。入组患儿均按呼吸道传染病进行隔离,给予对症支持治疗,54例(7.1%)患儿因并发重症肺炎、不同程度低氧血症转入重症监护室,其中34例(62.9%)患儿予机械通气治疗。入组患儿临床治愈共738例(97.5%),死亡19例,病死率为2.5%。结论儿童麻疹高发季节在春夏,好发于未接种麻疹疫苗<1岁的男性婴儿,并发肺炎最常见,易出现肺气漏,可导致死亡;需加强适龄儿童麻疹疫苗接种,尽量早识别、治疗,并重视并发症的诊断和治疗。Objective To investigate the epidemiological and clinical characteristics of hospitalized children with measles,and provide basis for measles prevention and control,clinical diagnosis and treatment.Methods Clinical data of 757 children with measles admitted to the Department of Pediatrics,Beijing Ditan Hospital,Capital Medical University from March 2009 to July 2019 were collected,retrospectively,including the onset time,gender,age,measles vaccination,measles patient contact history,clinical manifestations,complications,auxiliary examination,treatment and outcomes.Descriptive epidemiological methods were used to analyze the clinical data of 757 cases,the measurement data with normal distribution were expressed as mean±standard deviation(x±s),and the measurement data with skewed distribution were expressed as median(quartile)[M(P25,P75)];enumeration data were expressed as the number of cases(%).Results Total of 757 children with measles were collected,most[450 cases(59.4%)]occurred during March to May,including 505 boys(66.7%)and 252 girls(33.3%),the median age was[8.7(6.7,12)]months,among whom,children younger than one year old accounted for 71.7%(543/757);653 children(86.3%)were not vaccinated against measles.Clinical manifestations were rash[100%(757/757)],fever[99.5%(753/757)],cough[72.0%(545/757)]and measles mucosal plaque(Koplik plaque)[58.4%(442/757)],while the most common complication was pneumonia[77.5%(587/757)].There were 16 children(2.0%)with pulmonary air leakage,among whom,13 children(81.3%)with ediastinal emphysema and subcutaneous emphysema,including 7 children complicated with pneumothorax,and 3 children(18.7%)with pneumothorax alone.All the children were isolated according to respiratory infectious diseases and were given symptomatic supportive treatment.Total of 54 children(7.1%)were transferred to the Intensive Care Unit(ICU)because of severe pneumonia and different degrees of hypoxemia,and 34 cases(62.9%)of them were treated with mechanical ventilation.Total of 738 children(97.5%)were cured

关 键 词：儿童 麻疹 流行病学 临床特征 回顾性研究 

分 类 号：R725.1[医药卫生—儿科]