北京市急性腹泻病例流行病学特征和临床特征分析

Epidemiologic and clinical characteristics of acute diarrheal in Beijing,China

目的探讨北京市肠道门诊急性腹泻病例的流行病学特征和临床特征。方法研究对象为北京市肠道门诊2008年和2009年在4月1日至10月31日就诊急性初诊病例,7日内复诊病例和病程超过2个月的慢性病例被排除。资料来源于北京市肠道门诊早期预警系统。结果 2008年和2009年符合标准的病例数为159 244例和173 151例,发病并就诊率分别为9.75‰和10.24‰,男性比例分别为55.90%和54.30%。年龄呈双峰分布,0~1岁年龄组就诊并发病率最高,两年分别达到153.46‰和133.26‰,其次是20~30岁之间。病例集中在7~8月份,城区发病并就诊率明显高于郊区。超过80%的病例在72 h内就诊,病例每日发病高峰在早8点和14点、就诊高峰在9~10点和14点。大便多为稀便,两年分别占56.29%和57.70%,呕吐分别为21.18%和21.30%。结论急性腹泻病仍然是影响北京市公众健康的重要的疾病,儿童、特别是0~1岁婴儿是腹泻病的主要危害群体,其次是20~30岁青年群体。北京市不同地区发病并就诊率有较大差异,病例日分布和每日就诊时间分析应有助于医疗资源的合理利用。

Objective To investigate the epidemiological and clinical features of acute diarrheal disease in Beijing,China.Methods The data of acute diarrheal occurrences were collected from the early warning surveillance system of clinic diarrheal disease.The method of descriptive epidemiology was used to analyze the outpatients of acute diarrheal clinic visiting in Beijing between April 1st and October 31st in 2008 and 2009.Standardized questionnaires were also employed for collecting information.Results There were 158 064 and 173 151 outpatients of acute diarrheal in 2008 and 2009,respectively.The incidence rates of diarrheal and visiting to clinic were 9.75‰ and 10.24‰ for Beijing residents in 2008 and 2009,respectively.The age-specific incidence rates were the highest in children younger than 1 year old,which were 153.46‰ and 133.26‰,respectively,in 2008 and 2009.The other high incidence rate of age group was seen at the age group of 20 to 30 years.The incidence rates of diarrheal and visiting to clinic were higher in urban than that in suburb.July and October had higher incidence rates of the disease than other months did.Over 80% of patients visited the clinic in 72 hours.The daily peak times of incidences were at 8 O′clock and 14 O′clock,and the peak times of clinic visiting were at 9-10 O′clock and 14 O′clock.Loose stool was the most common symptom,which was respectively reported in 56.29% and 57.70% of the patients,followed by the symptom of vomiting,which was reported in 21.18% and 21.30% of patients in 2008 and 2009.Conclusion The high incidence rate of acute diarrheal disease is a serious threat to public health in Beijing,especially to children under 1 year old.The clinical characteristics of acute diarrheal may be helpful in proper allocation of medical resources.