长沙市甲型H1N1流感重症病例流行特征及危险因素分析

Analysis of Changsha City(H1N1) influenza severe cases risk factors

目的分析长沙市甲型H1N1流感重症病例流行特征及其危险因素。方法收集2009年5月1日~2010年10月31日长沙市辖区报告的甲型H1N1流感重症病例资料,采用1∶2频数匹配的病例对照研究方法,以非条件Logistic回归方法分析重症病例的危险因素。结果 2009年5月1日~2010年10月31日长沙市共报告甲型H1N1流感重症病例215例,其中193例痊愈,22例死亡,病死率为0.33%。重症病例危险因素的方差分析结果显示,年龄、性别、职业、发病至首次就诊时间间隔、地区、接触者有无症状和BMI的差异均有统计学意义。多因素logistic回归分析结果显示,年龄、地区、发病至就诊时间间隔是甲型H1N1流感由轻症转为重症的危险因素。相对于6~59岁组人群,〈5岁组和60~岁组人群发生重症的风险为2.016倍。相对于城市,农村发生重症的风险为0.193倍。发病2 d以上就诊的人群相对发病2 d以内就诊的人群,发生重症的风险为3.751倍。结论对于年龄〈5岁组或60~岁组、学生群体及城市居民,在出现甲型H1N1流感症状时应及早就医,防止发展为重症病例。

Objective To explore the risk factors of severe cases of Influenza H1N1 influenza. Methods Collected May 1, 2009 to October 31. 2010 the Changsha municipal districts health agencies report （ H1N1 ） influenza epidemics and severe cases data , then use software Epidata 3.1 establish a database and using descriptive epidemiological methods to analyses. A 1 ： 2 frequency number matched case - control study, risk factors for severe cases of non - conditional logistic regression analysis, statistical analysis tools is SPSS 13.0. Results Since May 26, 2009 （21 weeks）, the city of Changsha reported 215 severe cases of influenza A H1N1 influenza, of which 193 cases were cured, 22 patients died, the fatality rate of 0. 33%. Single risk factor for Chi -square analysis showed that age, gender, occupational, onset to the first treatment interval, region, contact asymptomatic, and BMI Their differences were statistically significant. Multivariate logistic regression analysis showed that age, region, on- set to treatment interval inhibitors of influenza H1N1 influenza from mild to severe risk factors. Relative to the 6 - 59 year - old crowd, under the age of five and people over the age of 60 the risk of severe 2. 016 times. With respect to the risk of severe urban, rural 0. 193 times. The crowd attending incidence of more than two days before the relative incidence of less than 2 days of treatment the crowd, the risk of severe 3.751 times. Conclusion Younger than 5 years of age or older than 60 years, groups of students and city residents （H1N1） flu-like symptoms should seek medical treatment as soon as possible to prevent the development of severe cases.