2009年四川省甲型H1N1流感重症及死亡病例流行病学分析

Epidemiology of Severe and Death Cases of 2009 Pandemic Influenza A(H1N1) in Sichuan,2009

目的了解2009年四川省甲型H1N1流感重症及死亡病例的流行病学特征,为制定防控和治疗对策提供客观依据。方法采用Excel2010建立数据库,SPSS18.0对数据进行描述性分析和单因素条件Logistic回归分析。结果重症病例主要集中在成都、德阳及绵阳地区,发生率最高地区为德阳、遂宁及自贡;重症病例与死亡病例均在11月达到高峰;男性病例较女性病例更易转变为重症病例(P=0.01),65岁及以上年龄段病例重症发生率最高,达50%;29.08%(57/196)的重症病例和38.10%(8/21)的死亡病例患有慢性基础性疾病,患有肺部疾病、心血管疾病及代谢性疾病的患者更容易转变成重症病例甚至死亡;84.54%(175/207)的重症病例和90.48%(19/21)的死亡病例出现不同程度的并发症,主要包括肺炎、呼吸衰竭、心力衰竭等。结论甲型H1N1流感患者拖延就诊时间可导致病情恶化。重症病例神经氨酸酶抑制剂的及时使用,将有效减少死亡的发生。

Objective To explore the epidemiological characteristics of the severe and deaths cases of 2009 pandemic influenza A（H1N1） in Sichuan in 2009,and provide evidence to develop the strategy for the prevention,control and treatment of the disease.Method The descriptive study and logistic regression analysis were conducted on the epidemic data by using SPSS 18.0.Results Severe cases were mainly distributed in Chengdu,Deyang and Mianyang,the highest incidences were reported in Deyang,Zigong,Suining.The incidence peaks of severe cases and deaths were in November.More severe cases occurred in males than in females（P = 0.01）,The incidence was highest in age group of ≥65 years（50%）.Up to 29.08% of severe cases（57/196） and 38.10% of deaths（8/21） had underlying medical conditions.More severe cases and deaths occurred in the patients with pulmonary disease,cardiovascular disease and metabolic disorders.Up to 84.54%（175/207） of severe cases and 90.48%（19/21） of death cases had complications,including pneumonia,respiratory failure,heart failure.Conclusions Delay in the treatment for the people infected with 2009 pandemic influenza A（H1N1） virus could lead to disease progression.The timely use of neuraminidase inhibitors could be effective to treat severe case and reduce death