2007～2009年中国六个市血小板减少性紫癜住院病例发生情况分析

Study on the Incidence of Hospitalized Thrombocytopenic Purpura Cases in 6 Cities in China,2007-2009

目的分析中国六个市血小板减少性紫癜(Thrombocytopenic Purpura,TP)住院病例(下同)的发生率及流行病学特征,为监测和评价接种疫苗后疑似预防接种异常反应(Adverse Events Following Immunization,AEFI)中TP的发生提供参考。方法采用分层多阶段整群抽样的方法,选择云南、江西、辽宁省的六个市,收集所有县(区、市,下同)级及以上医院2007～2009年TP住院病例的基本信息,采用描述性方法对TP发生率等有关指标进行流行病学分析。结果 2007～2009年,三个省六个市的县级及以上医院TP住院病例共3351例,3年平均发生率为3.84/10万;三个省调查地区的年平均发生率分别为3.94/10万、3.99/10万、3.67/10万。<15岁1427例,年平均发生率为8.38/10万。其中有感染等明确前驱危险因素的571例,占40.01%。<15岁儿童中,≤4岁儿童TP发生率均最高,三个省调查地区TP均呈现春季高发的特点。结论 2007～2009年,三个省六个市全人群及<15岁TP住院病例发生率较平稳,且均呈现季节性高发的特点,≤4岁TP发生率较高。在开展群体性预防接种活动时,应考虑TP季节性发生因素,接种前应询问受种者有无感染史、过敏史等危险因素并签署知情同意书,以减少偶合TP的发生;接种后应做好AEFI中TP的监测与评价。

Objective To analyze the incidence purpura （TP） in six districts selected in China, and epidemiological characteristics of thrombocytopenic and help to conduct surveillance and assessment on TP among adverse events following immunization （AEFI） after vaccination. Methods The basic information on hospitalized TP cases occurred in 2007-2009 were collected in all hospitals at county level and above in 6 cities in Yunnan, Jiangxi and Liaoning provinces, according to a multi-stage stratified cluster sampling method. The descriptive methodology is used for this study. Results During 2007-2009, 3351 hospitalized TP cases occurred with an average incidence rate of 3.84 in everyl00, 000 people. Among these, 1427 were under 15 years old with a incidence rate of 8.38 in 100,000 children aged 〈 15 years, and 571 （40. 01% ） with a definitely risk factors before onset. In 6 cities of Yunnan, Liaoning and Jiangxi provinces, average incidence rates during the 3 years were 3.94, 3.99, 3.67 in everyl00, 000 people respectively. The incidence in group ≤4 years old were the highest in the investigated areas in 3 provinces. TP represented an incidence pick in spring in the investigated areas in 3 provinces. Conclusions During 2007-2009, the incidence rates of hospitalized TP were relatively stable and represented seasonal characteristics, for both whole population and 〈 15 years old children in the investigated areas in 3 provinces. And the incidence in group ≤ 4 years old was high. These findings suggested that surveillance and assessment for TP, one of serious AEFI, shottld be enhanced for mass campaign vaccination, especially conducted in spring. Before vaccination, all recioients or their guardians should sign a written informed consents to reduce the risk factors such as infection and allergy history to avoid coincidental disease.