2013—2015年北京怀柔医院住院严重急性呼吸道感染病例流行病学和临床学特征分析

Analysis on epidemiological and clinical characteristics of hospitalized cases with SARI in Huairou Hospital of Beijing from 2013-2015

目的探讨流行性感冒（流感）相关疾病住院病例严重急性呼吸道感染（SARI）的流行病学特征和临床特征。方法对2013年12月—2015年4月北京怀柔医院内SARI病例进行流行病学调查分析和流感病毒核酸检测。结果共监测SARI病例798例,占入院病例的17.04%,男性454例（56.89%）,中位年龄M=28岁（IQR：3-67）;0-4岁组（31.95%）和60岁以上年龄组（30.95%）报告病例数最多;发热（95.74%）、咳嗽（92.11%）、X线或CT表现为肺部异常（80.95%）是最常见的临床症状和体征;共264例（33.08%）出现并发症,以并发肺炎（21.43%）最常见。检出流感阳性189例（阳性率23.68%）,以乙型B/Yamagata（46.03%）和甲型H3N2（44.44%）为主,各年龄组间流感阳性检出率差异有统计学意义（χ2=9.79,P=0.005）。结论 SARI病例以〈5岁年龄组和≥60岁人群为主;SARI监测是对门诊流感监测的补充,但今后还应加强对其他多种呼吸道病原体的检测。

[Objective]To identify the epidemiological and clinical characteristics of influenza-related diseases hospitalized cases with severe acute respiratory infection（SARI）.[Methods]Epidemiological investigation and influenza virus nucleic acid detection were conducted among SARI patients in Huairou Hospital from December 2013 to April 2015. [Results]Totally 798 SARI cases were monitored,accounted for 17.04% of all hospitalized cases,there were 454 male cases（56.89%）,and median age（M）was 28 years old（IQR：3-67）. Most of cases were children aged 0-4 years old（31.95%）and elderly people over 60 years old（30.95%）.The most common clinical symptoms and signs were fever（95.74%）,cough（92.11%）and abnormal chest X-ray or CT performance（80.95%）. 264 cases（33.08%）had complications,and the pneumonia was most frequent（21.43%）. 189 cases were positive for the influenza virus nucleic acid with the positive rate of 23.68%,which were dominated by influenza B/Yamagata（46.03%）and influenza A/H3N2（44.44%）. The difference in the positive rate was statistically significant among different age groups（χ2=9.79,P =0.045）.[Conclusion]SARI cases have mainly occurred in winter and spring,and most of cases are children under 5years old and elderly people over 60 years old. SARI surveillance is a supplement to the clinic influenza surveillance. However,it is necessary to strengthen the detection of various respiratory pathogens in SARI cases.