北京市2004-2009年痢疾样病例流行病学特征分析

Analysis of the epidemiological characteristics of dysentery-like cases from 2004 to 2009 in Beijing

目的分析2004-2009年北京市痢疾样病例的流行病学特征和病原学变迁情况，为科学防治提供数据支持。方法通过中国疾病预防控制信息系统和日常监测中获取疾病发病资料数据，由北京市疾病预防控制中心获得病原学监测结果，应用描述流行病学的方法进行统计分析。结果2004-2009年菌痢报告发病率波动在142．78／10万～240／10万，发病高峰为5月21日至9月30日；近郊区发病率高于城区和远郊；男性发病率高于女性（X＾2=1962．57，P〈0．001），小年龄组和青年组发病率较高，其中0～岁组发病率最高，达2259／10万，为50～岁年龄组的25．47倍；北京市痢疾病原以福氏和宋内志贺菌为主，2004－2006年以福氏为主，2007年起宋内志贺菌逐渐成为优势菌株，病原学监测结果显示北京市痢疾诊断的符合率较低，最高的2005年仅为19．14％，2008年低至3．30％。结论菌痢仍是影响公众健康的一种重要传染病，但误诊率较高，诊断后应慎用抗菌素。

Objective To learn the epidemiological characteristics and etiology characteristics of dysentery-like cases in Beijing from 2004 to 2009. Methods We collected data of dysentery-like cases from China information system for disease control and prevention and daily monitoring. And we analyzed the distribution of time, regional and population of dysentery-like cases and describe the characteristics of etiology from 2004 to 2009 in Beijing. Results Incidence rate of dysentery-like diseases was fluctuated from 142.78/100 000 to 240/100 000 each year. The peak was appeared from May 21 to Sep. 30 these years. There were significant differences in gender and regional distribution. Incidence rate was higher in male and in urban areas, Infants, children and the youths may have higher incidence rate. The infants less than 1 years old showed the highest incidence rate of 2 259/100 000, 25.47 times higher than the incidence rate of 50～ age group. Flexneri and Shigella sonnei were the main infection agents of bacillary dysentery. From 2004 to 2006, Flexneri was the main infection agent. Since 2007, Shigella became the main infection agent. Coincidence between clinical diagnosis and lab diagnosis was at a low level. The highest coincidence rate happened in 2005, which was only 19.14%, and in 2008 the coincidence rate was only 3.30 %. Conclusions Dysentery is still an important infectious diease which affects the public health. However, with high misdiagnosis rate, antibiotic should be carefully used in clinical practice.