中国六个市2007～2009年过敏性紫癜住院病例发病情况分析

Study on the Incidence of Hospitalized Henoch-Schnlein Purpura Cases in 6 Cities in China,2007-2009

目的分析中国六个市过敏性紫癜(Henoch-schnlein Purpura,HSP)的发生率及流行病学特征,为开展预防接种的安全性评价提供参考依据。方法采用分层多阶段整群抽样的方法,选择江西省南昌、宜春、景德镇市,云南省昆明、曲靖市,辽宁省大连市等六个设区的市,收集所有县级及以上医院2007～2009年HSP住院病例的基本信息,采用描述性方法对HSP等有关信息进行流行病学分析。结果 2007～2009年,三省六个市的县级及以上医院HSP住院病例共7743例,年平均发病率为8.82/10万;<15岁儿童5677例,年平均发病率为33.86/10万;其中有感染等明确前驱危险因素的1639例(占28.87%)。江西、云南、辽宁三省的HSP年平均发病率分别为4.08/10万、15.27/10万、6.28/10万;<15岁儿童年平均发病率分别为14.48/10万、59.42/10万、24.59/10万。云南省两个市HSP呈现春季高发的特点,江西、辽宁省四个市HSP均呈现秋冬季高发的特点。三省六个市5～9岁儿童HSP发病率均最高。结论 2007～2009年,三省六个市全人群及<15岁儿童HSP住院病例发病率较平稳,但不同地区发病率差别较大,且呈现不同的季节性高发特点,提示选择开展群体性预防接种活动的时机应考虑HSP季节性因素;接种前应仔细询问受种者有无感染史、过敏史等危险因素,以减少偶合HSP的发生。

Objective To analyze the incidence and epidemiological characteristics of Henoch-Schonlein Purpura（HSP）in selected districts in China, and to assess safety of vaccination. Methods The basic information on hospitalized HSP cases occurred in 2007-2009 were collected from hospitals at county level in 6 cities from Yunnan, Jiangxi , and Liaoning provinces, by multi-stage stratified cluster sampling method. The descriptive methodology is used for this study. Results During 2007-2009, 7743 hospitalized HSP cases occurred with an average incidence rate of 8.82 per 100, 000 people. Among them, 5677 children were 〈 15 years old, incidence rate was 33.86 per 100000, and 1639 （28.87%） with a definitely risk factors before onset. In 6 cities, average incidence rates among 3 years old children were 4.08, 6.28, 15.28 per 100, 000 people respectively, and 14.48, 24.59, 59.42 per 100,000 in children aged 〈15 years. Incidence pick was in spring in 2 cities of Yunnan, and in autum and winter in 4 cities in Jiangxi and Liaoning provinces. The incidence in group of aged 5-9 years were the highest in the investigated areas in 3 provinces. Conclusions During 2007-2009, the incidence rates of hospitalized HSP were relatively stable for whole population and 〈 15 years old children in the investigated areas in 3 provinces. However, there were apparently differences in incidence and seasonal characteristic from different provinces. These findings suggested that the time for mass campaign vaccination should be conducted according the local seasonal characteristic of HSP. Before vaccination, all recipients or their guardians should be asked carefully by vaccination providers to avoid risk factors, such as infection and allergy history.