2015年4月-2016年4月北京市房山区流感相关住院病例的临床与病原学特征分析

Clinical and etiological features of influenza-associated hospitalized cases in Fangshan District,Beijing,April 2015 to April 2016

目的了解北京市房山区流感相关住院病例的流行病学及临床特征,为房山区流感相关住院病例的防治提供依据。方法对2015年4月-2016年4月在北京市房山区良乡医院流感相关住院病例的病人进行监测,采集相关病例咽拭子,并进行流感病毒实验室检测,同时收集采样标本的临床特征、既往病史、疫苗接种情况等相关信息。结果共纳入病例1 093例,流感病毒检出率为7.59%,BV型占所有阳性病例的61.45%,流感主要在2016年第2~12周高发。流感病毒检测阳性病例中咳嗽(92.77%vs.76.14%)、咳痰(53.01%vs.42.48%)、支气管炎(28.75%vs.13.17%)、慢阻肺(9.64%vs.1.39%)、高热惊厥发生率(5.00%vs.1.19%)明显高于阴性组(P<0.05),咽痛(15%vs.25.74%)、急性扁桃体炎(1.25%vs.14.06%)低于阴性对照组。纳入研究的流感相关住院病例的中位数6 d。住院时间与年龄分组密切相关,10~<20岁年龄组(OR=0.066,0.029~0.150,P=0.000),20~<30岁年龄组(OR=0.314,0.111~0.814,P=0.033),30~<40岁年龄组(OR=0.266,0.077~0.917,P=0.035)对住院流感病例的住院时间具有保护作用。结论房山区流感相关住院病例检出率最高的是流感B型,流感病毒可能加重呼吸道感染,10~<40岁年龄组对流感住院病例的严重性有保护作用。

Objective To investigate the epidemiological and clinical characteristics of influenza-associated hospitalization cases in Fangshan District, Beijing, and to provide evidence for their prevention and treatment. Methods A study was conducted among influenza-associated patients hospitalized in Liangxiang Hospital, Fangshan District, Beijing from April 2015 to April 2016. The patients’ nasopharyngeal swabs were sampled for laboratory testing; meanwhile, their related information, such as clinical characteristics, medical history and vaccination history was collected. Results A total of 1,093 influenza-associated hospitalized patients were enrolled in this study, and the positive detection rate of influenza viruses was 7.59%. Influenza B virus accounted for 61.45% of the detected viruses. The peak season of influenza epidemics was from the 2nd week to the 12th week in 2016. The incidence rates of cough （92.77% vs. 76.14%）, expectoration （53.01% vs. 42.48%）, bronchitis（28.75% vs. 13.17%）, chronic obstructive pulmonary （9.64% vs. 1.39%）, high fever and convulsion （5.00% vs.1.19%） were all significantly higher in the influenza viruse-positive cases than in the influenza viruse-negative ones （P〈0.05）, while the incidence rates of sore throat （15% vs. 25.74%） and acute tonsillitis （1.25% vs.14.06%） were both lower in the influenza viruse-positive cases than in the negative control cases. The median duration of hospital stay for the influenza-associated hospitalized patients was 6 days. The duration of hospital stay was closely related to the age group. The age groups of 10-〈20 years （OR=0.066, 0.029-0.150, P=0.000）, 20-〈30 years （OR=0.314, 0.111-0.814, P=0.033） and 30-〈40 years （OR=0.266, 0.077-0.917, P=0.035） played a protective role in the hospitalization time of the influenza-associated hospitalized cases. Conclusions Influenza B virus is the most predominant pathogen in the influenza-associated hospitalized patients in Fangshan District. Influenza viruses may aggravate respiratory tract infections. The age of 10-〈40 years is a protective factor of the severity of the influenza-associated hospitalized cases.