综合医院和儿童专科医院流感病原学监测结果比较分析

Comparative analysis of influenza etiology surveillance in general hospital and children′s hospital

目的通过对北京市西城区综合医院和儿童专科医院流行性感冒(简称流感)病原学监测结果进行比较分析,了解儿童流感流行规律,为制订流感防控措施提供依据。方法由两家哨点医院每周随机采集流感样病例的咽拭子共40份,提取病毒RNA,应用RT-PCR方法进行检测。结果综合医院和儿童专科医院流感病原学监测阳性率(21.8%vs.14.9%)比较,差异有统计学意义(P<0.001)。综合医院流感病原学监测阳性率最高的为≥60岁年龄组(31.3%)。儿童专科医院阳性率最高的为>4~14岁年龄组(26.7%)。综合医院和儿童专科医院11月至次年4月均处在流感高峰期,呈现典型的北方地区流行特征,但儿童专科医院在1月和2月有个流行小低谷。两家医院均存在甲型H3亚型、甲型H1N1和乙型3种流感病毒流行,并以甲型H3亚型和乙型流感病毒为优势毒株。结论以综合医院作为参照,儿童专科医院的流感监测质量稳定可靠。儿童专科医院缺少>24~<60岁年龄组和≥60岁年龄组是两家医院间的流感病原学监测阳性率差异有统计学意义的主要原因。儿童的流感疫苗接种率较高,疫苗保护效果比较好。

Objective By comparing and analyzing the etiological monitoring results of influenza in Xicheng District general hospital and children′s Hospital,to explore the epidemic regularity of influenza in children,so as to provide the basis for developing influenza prevention and control measures.Methods A total of 40 swabs of influenza samples were collected every week from two sentinel hospitals,and the virus RNA was extracted and detected by RT-PCR method.Results There was a statistically significant difference in positive rate of influenza pathogen surveillance between general hospitals and children′s hospitals （21.8%vs.14.9%）（P〈0.001）.In the general hospital,the positive rate was highest in people aged≥60 years old （31.3%）.In the children′s hospital,the positive rate was highest in people aged〉4—14 years old （26.7%）.Both hospitals had an epidemic peak of influenza from November to December of next year,it was typical influenza epidemic of the North area.But the children′s hospital had a epidemic trough in January and February.In both hospitals,the circulating strains were H3,H1N1,type B,the predominant type was H3 and type B.Conclusion Taking the general hospital as a reference,the quality of influenza surveillance in the children′s hospital was relatively stable and reliable.Lack of the people aged〉24—60 years old and aged≥60 years old in children′s hospital,is the key reason of the statistically significant difference of the positive rate,between the general hospital and the children′s hospital.Children′s influenza vaccination rate is higher than the other age group,and the protective effect of vaccine is better.