甘肃省发热呼吸道症候群病原监测水平分析

Analysis of pathogen monitoring on febrile respiratory syndrome in Gansu

目的分析并评价2009-2011年和2012-2015年两时间段甘肃省发热呼吸道症候群(FRS)病原的检测情况及监测能力,为提高其监测质量提供依据。方法利用2009-2015年甘肃省13家哨点医院的监测数据,描述性研究两时间段各病原的检测检出及阴性病例症状分布情况。结果两时间段甘肃省FRS所有细菌和病毒的总检测率分别由0. 5%、8. 7%上升至24. 9%、76. 2%,且差异均有统计学意义(χ~2=1 072. 054,P <0. 05和χ~2=3 382. 581,P <0. 05)。两时间段所有细菌的总阳性率分别为0. 3%和62. 4%,所有病毒的总阳性率由38. 4%下降至27. 9%,总阳性率在两时间段的差异均有统计学意义(χ~2=8. 622,P <0. 05和χ~2=16. 317,P <0. 05);对两时间段的阴性病例进行症状分析,结果显示阴性病例均以中重度症状为主。结论 2009-2011年和2012-2015年甘肃省FRS的监测能力有所提升,但仍存在病原检测率与阳性率较低等问题,应加大所有病原尤其是细菌的检测力度,加强对阴性病例的重复检测,以提高病原的检出水平,进一步提高甘肃省FRS的监测质量和监测能力。

Objective To analyze and evaluate the pathogenic status of testing and detecting with monitoring system on febrile respiratory syndrome（ FRS） in Gansu province during the period of 2009-2011 and 2012-2015,to evaluate the monitoring capacity and explore the possible problems of monitoring system and provide the evidence for improving the monitoring quality. Methods The monitoring data of FRS from 2009 to 2015 in several sentinel hospital were collected and the detection of pathogens and the distribution of symptoms in negative cases were analyzed by descriptive analysis. Results During the two time,the total detection rate of all bacteria and all viruses raised from 0. 5%,8. 7% to 24. 9%,76. 2%,respectively,the differences of the detection rates between two time were statistically significant（ χ2= 1 072. 054,P〈0. 05 and χ2= 3382. 581,P〈0. 05）; the total positive rates of all bacteria（ 0. 3% and 62. 4%,individually） significantly increased,but the total positive rates of the virus decreased from 38. 4% to 27. 9%,the differences of the positive rate between two time were statistically significant（ χ2= 8. 622,P〈0. 05 and χ2= 16. 317,P〈0. 05）; the results of analyzing the symptoms degree of negative cases showed negative cases had a heavy symptom and were given priority to moderately severe cases. Conclusion The monitoring capacity of FRS improved evidently in Gansu province from the period of 2009-2011 to the period of 2012-2015,but there are still some problems,such as slower detection rate and positive rate of pathogen,it can improve the positive rate of pathogen and the monitoring capacity of fever respiratory syndrome in Gansu province by strengthen the detection of all pathogen（ especially bacteria） and the retesting of the negative cases.