394例学龄儿童流感样病例临床调查及疫苗接种状况分析

Clinical investigation and analysis of influenza vaccination status in 394 school-aged children with influenza-like illness

目的分析2014年冬季学龄儿童流感样病例(influenza-like illness,ILI)的临床特点及疫苗接种情况,为临床诊疗提供参考,并为流感防控工作提供科学依据。方法针对来本院开具复课证明的394例学龄儿童ILI,调查其一般情况、临床特点、预后及疫苗接种等情况。根据是否注射疫苗分为2组,进行回顾性病例对照研究。应用SPSS13及stata12进行统计分析,计量资料采用t检验或秩和检验,计数资料采取χ2检验,对病程的影响因素采用线性回归分析。结果学龄儿童ILI疫苗接种率为26.6%,未接种疫苗组与接种组病例在性别、年龄、伴有咳嗽、咽痛、头痛、卡他症状、热程及病程的持续时间方面比较,差异均无统计学意义;未接种疫苗组中性粒细胞计数低于接种组,差异有统计学意义;未接种疫苗组最高体温高于接种组,差异有统计学意义;回归分析结果显示:白细胞增高、体温高峰高及伴有咳嗽、头痛是学龄儿童ILI病程延长的独立危险因素。结论接种疫苗可以预防流感,并能缓解学龄期儿童ILI症状。在流感季节,应该加强学龄儿童的疫苗注射工作的宣传。

Objective To understand the clinical characteristics and influenza vaccination status of school-aged children with influenza-like illness（ILI）, so as to provide the reference for clinical diagnosis and treatment, and improving the influenza prevention and control work. Methods A total of 394 school-aged children with ILI, who needed the proof of full recovery for class in the hospital, were investigated. All the cases were divided into two groups according to whether or not using the vaccine, and were studied with the retrospective case-control comparative study method. The results were analyzed by using SPSS 13 and Stata 12, and the comparison of quantitative data was performed by using independent t test or rank test, and the qualitative data were compared by using chi-square test, and the factors affecting the duration of disease were analyzed by using the linear regression analysis. Results The percentage of school-aged children with ILI vaccination was 26.6%. There were no significant differences between the unvaccinated group and vaccinated group in gender, age, cough, sore throat, headache, catarrhal symptoms, and the duration of fever and disease. The neutrophil count of the patients of the unvaccinated group was less than that of the vaccinated group with a statistically significant difference.The maximum temperature of the patients of the unvaccinated group was higher than that of the vaccinated group with a statistically significant difference. The regression analysis showed that increased WBC, the high peak temperature associated with cough, and headache were independent risk factors for extending the duration of ILI. Conclusion The vaccination can prevent influenza and ease the symptoms of ILI for school-aged children. In the influenza season, we should strengthen the health education of vaccination for school-aged children.