2016-2021年我国儿童病毒性心肌炎流行特征及疾病负担分析  

Analysis of the epidemic characteristics and disease burden of hospitalized children with viral myocarditis in China from 2016 to 2021

作　　者：黄陆慈 邵魏[2] 郭凌云[3] 付艺亮 李飞 徐会 冯国双[4] 高路[2] 谢正德[1] 袁越[2] 刘钢[3] 陈祥鹏[1] Huang Luci;Shao Wei;Guo Lingyun;Fu Yiliang;Li Fei;Xu Hui;Feng Guoshuang;Gao Lu;Xie Zhengde;Yuan Yue;Liu Gang;Chen Xiangpeng(Beijing Key Laboratory of Pediatric Respiratory Infection Diseases,Key Laboratory of Major Diseases in Children,Ministry of Education,National Clinical Research Center for Respiratory Diseases,Research Unit of Critical Infection in Children,Chinese Academy of Medical Sciences,2019RU016,Laboratory of Infection and Virology,Beijing Pediatric Research Institute,Beijing Children′s Hospital,Capital Medical University,National Center for Children′s Health,Beijing 100045,China;Department of Cardiology,Beijing Children′s Hospital,Capital Medical University,National Center for Children′s Health,Beijing 100045,China;Department of Infectious Diseases,Beijing Children′s Hospital,Capital Medical University,National Center for Children′s Health,Beijing 100045,China;Big Data Center,Beijing Children′s Hospital,Capital Medical University,National Center for Children′s Health,Beijing 100045,China)

机构地区：[1]国家儿童医学中心、首都医科大学附属北京儿童医院、北京市儿科研究所感染与病毒研究室、儿科重大疾病研究教育部重点实验室、国家呼吸系统疾病临床医学研究中心、儿童呼吸道感染性疾病研究北京重点实验室、中国医学科学院儿童危重感染诊治创新单元,北京100045 [2]国家儿童医学中心、首都医科大学附属北京儿童医院心脏内科,北京100045 [3]国家儿童医学中心、首都医科大学附属北京儿童医院感染内科,北京100045 [4]国家儿童医学中心、首都医科大学附属北京儿童医院大数据中心,北京100045

出　　处：《中华实验和临床病毒学杂志》2024年第4期432-438,共7页Chinese Journal of Experimental and Clinical Virology

基　　金：国家自然科学基金(82172245);国家重点研发计划(2023YFC2306002)国家科技重大专项(2018ZX10201002-003-009);北京市自然科学基金-海淀原始创新联合基金(L192014);中国医学科学院医学与健康科技创新工程(2019-I2M-5-026);北京市卫生健康委员会改革与发展项目。

摘　　要：目的分析我国2016-2021年儿童病毒性心肌炎(viral myocarditis,VMC)的流行特征及疾病负担,为我国儿童VMC的诊疗及防控提供基础参考数据。方法通过福棠儿童医学发展中心收集我国2016-2021年23个省份(直辖市)27家儿童医院或妇幼保健院中的VMC住院患儿病历首页信息,对我国儿童VMC流行病学、死亡情况及疾病负担进行描述性统计分析。结果本研究共纳入7647599例住院患儿,其中VMC患儿1646例。2016-2021年VMC住院患儿人数年度分布分别为173例、227例、313例、301例、295例和337例,住院占比分别为14.9/10万人、17.9/10万人、23.0/10万人、20.5/10万人、26.5/10万人和26.4/10万人;VMC患儿的住院占比总体呈逐年升高趋势(P<0.001)。不同年龄组患儿的住院占比呈现随发病年龄增大而升高的趋势(P<0.001),12-≤18岁年龄组患儿的住院占比最高。西北地区的住院患儿人数(625例,38.46%)及住院占比(64.9/10万人)最高,华东地区次之。本研究中共有68例死亡患儿,VMC住院患儿病死率为4.13%,不同性别、年龄组、季节、年份的VMC住院患儿病死率无明显统计学差异。所有VMC患儿住院时长中位数为10天(IQR 6,21),住院费用中位数为11842.30元(IQR 6969.22,19714.78)。其中,死亡患儿住院时长中位数仅1天(IQR 1,3),而住院费用中位数可达8874.03元(IQR 5277.94,56151.59),VMC患儿死亡发生迅速,造成严重的疾病负担。结论VMC患儿住院占比呈逐年升高趋势,12-≤18岁年龄组患儿住院占比最高;VMC住院患儿总体病死率可达4.13%,且死亡发生迅速。ObjectiveThis study aimed to provide basic data for the prevention,diagnosis and treatment of pediatric viral myocarditis(VMC)in China through analyzing the epidemic characteristics and disease burden of pediatric inpatients with VMC from 2016 to 2021.MethodsWe performed a descriptive statistical analysis to the age,genders,seasons,regions and hospitalization cost and days of pediatric VMC inpatients and the death.All of the information was obtained from 27 Children′s hospitals or Maternal and Child Health hospitals of 23 provinces of China from 2016 to 2021.ResultsA total of 7647599 cases including 1646 VMC inpatients were admitted into our study.The annual numbers of hospitalizations were 173,227,313,301,295 and 337,with the hospitalized constituent ratios being 14.9/100000,17.9/100000,23.0/100000,20.5/100000,26.5/100000 and 26.4/100000 from 2016 to 2021.In recent 6 years,the proportion of VMC hospitalizations had increased yearly(P<0.001),and had associated with the onset age(P<0.001).Aged 12-≤18 years owned the highest hospitalized constituent ratio.The Northeast of China owned the largest number of VMC inpatients,and the East second to it.Among the 1646 VMC children,there were 68 deaths,with the hospitalized case fatality rate of 4.13%.There were no significant differences between genders,age,seasons,years and fatality rate of VMC inpatients.For the diseases burden,the median of hospitalization days of all VMC inpatients was 10 days(IQR 6,21),and the median of hospitalization cost was 11842.3 RMB(IQR 6969.22,19714.78).The median of hospitalization days of deceased VMC children was only 1 day(IQR 1,3),the median cost could be 8874.03 RMB(IQR 5277.94,56151.59).ConclusionsIn this study,we found that proportion of hospitalization of VMC children increased year by year,adolescence might be a risk factor of VMC.The fatality of VMC inpatients could be up to 4.13%,and the death led to a huge economic burden of society,family and individuals.

关 键 词：病毒性心肌炎 儿童 流行病学 疾病负担 

分 类 号：R725.4[医药卫生—儿科] R181.3[医药卫生—临床医学]