锦州市2017-2018年流感重症肺炎监测结果分析

Analysis on surveillance results of severe influenza pneumonia in Jinzhou from 2017 to 2018

目的分析锦州市流感重症肺炎监测结果,为制定流感防控措施提供依据。方法 2017-2018年由2家哨点医院采集流感样及流感重症肺炎病人的鼻咽拭子或肺液标本,用RT-PCR方法检测甲、乙型流感病毒核酸,并用MDCK细胞进行病毒分离培养,采用血凝抑制试验进行病毒亚型鉴定。结果 2017-2018年共采集流感样标本1 775份,分离出流感病毒31株,分离率为1.75%;采集流感重症肺炎标本78份,病毒核酸检测阳性率为53.85%,共分离出流感毒株35份,分离率达44.87%,经血抑试验检测,所有毒株均为甲型H1N1;流感重症肺炎在各月份间的毒株阳性率差异有统计学意义(χ^2=30.060,P<0.05),毒株分离高峰出现在2018年2月和2017年12月,其阳性率分别为80.00%和71.43%;流感重症肺炎标本在各年龄组间的阳性率差异有统计学意义(χ^2=27.391,P<0.05),其中51~60岁年龄组的阳性率最高,为85.71%,主要发病群体为41~50岁与51~60岁年龄组。结论2017-2018年锦州市流感重症肺炎为甲型H1N1流感病毒,未发现H5N1、H7N9等流感病毒;中老年人群流感重症肺炎阳性率较高,应加强对中老年人群的监测。

Objective To analyze the surveillance results of severe influenza pneumonia in Jinzhou, and to provide the evidence for formulating influenza prevention and control measures. Methods From 2017 to 2018, nasopharyngeal swab or lung fluid specimens of influenza-like patients and influenza patients with severe pneumonia were collected from two sentinel hospitals, the specimens were tested through RT-PCR to detect nuclear acid of influenza virus A and B and isolated by MDCK cells and the subtypes were identified by hemagglutination inhibition(HI) test. Results A total of 1775 influenza-like specimens were collected and 31 cases of influenza virus were identified from 2017 to 2018, with the separation rate was 1.75%;a total of 78 severe influenza pneumonia specimens were collected and the positive rate of nuclear acid of virus was 53.85%, a total of 35 cases of influenza virus were isolated and the separation rate was 44.87%. After hemagglutination inhibition(HI) tested, all the influenza viruses were influenza virus A(H1 N1);there was significant difference in the positive rate of severe influenza pneumonia strains in each month( χ^2=30.060, P<0.05);the peak periods of virus isolation were in February 2017 and December 2018 and the positive rate was 80.00% and 71.43%, respectively;there was significant difference in the positive rate of severe influenza pneumonia among different age groups(χ^2=27.391, P<0.05), among them, the positive rate of 51-60 years old group was the highest(85.71%), the main incidence groups were 41-50 years old and 51-60 years old.Conclusion The severe influenza pneumonia is caused by influenza virus A(H1 N1) and influenza virus H5 N1, H7 N9 are not found in Jinzhou from 2017 to 2018;the positive rate of severe influenza pneumonia in middle-aged and elderly group is high, so it is necessary to strengthen the surveillance of middle-aged and elderly group.