2017-2018年冬春季榆林地区甲型H1N1流感病毒流行病学特点分析

Epidemiological characteristics of influenza A(H1N1)virus in Yulin city in winter and spring of 2017-2018

目的:探究2017-2018年冬春季榆林地区甲型H1N1流感病毒发病情况,并进行流行病学特点分析。方法:选取2017-2018年冬春季榆林地区10家医院收治的急性呼吸道感染患者1976例进行回顾性分析,采集患者呼吸道标本并进行流感病毒检测。将甲型H1N1流感病毒呈阳性的设为H1N1阳性组,流感病毒阴性的设为流感病毒阴性组。分析2组临床特点与流行病学特征,并分析感染患者职业分布情况。结果:实验室检测结果显示,1976例急性呼吸道感染患者中,H1N1阳性组患者201例(10.17%),流感病毒阴性组患者1574例(79.66%)。2组患者不同年龄组比较,差异有统计学意义(χ^2=16.291,P<0.05)。H1N1阳性组中19.40%患者患≥1种慢性基础疾病,主要为合并慢性肺部疾病、支气管哮喘。H1N1阳性组排痰性咳嗽、腹泻发生率均显著低于流感病毒阴性组(P值均<0.05),咽痛、呕吐、肺部听诊异常、X线/CT表现异常均显著高于流感病毒阴性组(P值均<0.05)。实验室检查显示,H1N1阳性组白细胞计数、中性粒细胞计数均低于流感病毒阴性组(P值均<0.05)。H1N1阳性组患者职业分布显示,学生发病率最高(39.80%)。3例重症患者死亡,病死率为1.49%。结论:2017-2018年冬春季榆林地区甲型H1N1流感病毒发病率较高,主要表现为发热、咳嗽、肺部听诊异常,且白细胞计数、中性粒细胞计数下降。该病年龄分布差异性大,应开展宣传教育,提高学生、合并慢性肺部疾病等高发群体自我防护能力。

Objective To investigate the incidence of influenza A(H1N1)virus in Yulin in winter and spring of 2017-2018 and to analyze its epidemiological characteristics.Methods 1976 patients with acute respiratory tract infections admitted to 10 hospitals in Yulin area from winter to spring of 2017-2018 were selected.Respiratory tract specimens were collected and influenza viruses were detected.The H1N1 influenza virus positive was set as the H1N1 positive group,and the influenza virus negative was set as the influenza virus negative group.The clinical and epidemiological characteristics of two groups were analyzed,and the occupational distribution of infected patients was analyzed.Results Laboratory test results showed that among the 1976 patients with acute respiratory infections,10.17%of patients with new type A H1N1 influenza(n=201),and influenza virus negative accounted for 79.66%(n=1574).The difference between the two groups of different age groups was statistically significant(χ^2=16.291,P<0.05).19.40%of patients in the H1N1 positive group suffered from≥1 chronic underlying diseases,mainly combined with chronic lung diseases and bronchial asthma.The incidences of expectorant cough and diarrhea in the H1N1 positive group were significantly lower than those in the influenza virus negative group(all P<0.05),sore throat,vomiting,abnormal lung auscultation,and abnormal X-ray/CT findings were significantly higher than those of influenza virus negative group(all P<0.05).Laboratory examination showed that the white blood cell count and neutrophil count of the H1N1 positive group were lower than those of the influenza virus negative group(all P<0.05).The occupational distribution of H1N1 positive patients showed that the incidence of students was the highest(39.80%).Three severely ill patients died with a case fatality rate of 1.49%.Conclusions The incidence of influenza A(H1N1)virus is high in Yulin area in winter and spring of 2017-2018.The main manifestations are fever,cough,abnormal lung auscultation,decreased white blood cell count and neutrophil count.There are great differences in age distribution.The incidences of patients with chronic pulmonary diseases and asthma are higher.Publicity and education should be carried out to improve the self-protection ability of students and other high-risk patients.