212例不明原因肺炎的分布特点及临床特征

Clinical Analysis of 212 Cases of Unidentified-Reason Pneumonia

目的:分析212例不明原因肺炎的分布特点和临床特征。方法:收集医疗机构报告的212例不明原因肺炎病例资料,分析病例的流行分布特点、禽类暴露比例和临床特点。结果:212例不明原因肺炎病例发病高峰为3～4月,以黔东南州和黔南州医疗机构报告为主,男女性别比为2.16∶1,中老年人多发,禽类暴露比例为51.89%;病例主要以发热、咳嗽等症状就诊,从发病到诊断间隔为病后(6.51±5.92)d;医院诊断符合率69.34%,省级高于市级、市级高于县级(χ~2=13.503,P<0.001);通过实验室检测共检出14例人感染H7N9禽流感病例,15例流感病例,病原学诊断率为13.68%。结论:不明原因肺炎为春季高发疾病,不明原因肺炎病例诊断是发现人感染H7N9禽流感病例的重要途径,但病例的诊断符合率和病原学诊断率不高。

Objective: To investigate the distribution characteristics and clinical features of 212 cases of unidentified reason pneumonia. Methods: Collecting the data of 212 cases of unidentified reason pneumonia reported by various medical institutions, analyzing the epidemic distributing characteristics, poultry exposure ratio and clinical features. Results: The peak of incidence of unidentified reason pneumonia was from March to April, mainly concentrated Qiandongnan counties and Qiannan counties;the reported ratio of male to female was 2.16∶1, the middle and elderly people were the most affected age group, and the proportion of exposure to poultry was 51.89%. Main symptoms for visiting hospitals were fever and cough. The intervals between symptom onset and diagnosis were 6.51±5.92 days;the diagnostic coincidence rate was 69.34%, which provincial level hospital was higher than the city level, and the city level was higher than the county level(χ~2=13.503,P<0.001). The results of laboratory tests were 14 cases of human infection with avian influenza(H7 N9), 15 cases of Influenza,the pathogenic diagnosis rate was 13.68%. Conclusion: Unidentified reason pneumonia is a high incidence disease in winter and spring, the diagnosis of unidentified reason pneumonia is an important way to detect human infection with H7 N9 avian influenza cases;however, the diagnostic coincidence rate and pathogenic diagnosis rate were not very high.