2014-2018年甘肃省陇南市流行性乙型脑炎病例死亡影响因素分析

Analysis of influencing factors of death of epidemic Japanese encephalitis cases in Longnan City,Gansu Province from 2014 to 2018

目的了解甘肃省陇南市流行性乙型脑炎(简称乙脑)病例死亡的影响因素。方法导出中国疾病预防控制信息系统乙脑监测信息报告管理系统中,2014-2018年发病且现住址为陇南市的乙脑病例资料。设计"陇南市流行性乙型脑炎个案调查表",对纳入调查的病例采用回顾性研究,收集其人口学资料、就诊信息、发病信息、临床分型及慢性基础性疾病患病情况等,分析乙脑病例的特征及影响其死亡的相关因素。结果2014-2018年陇南市共报告乙脑病例260人,完成调查259人。其中,年龄≥60岁的病例70人(27.0%),重型和极重型病例67人(25.9%),患有慢性基础性疾病病例55人(21.2%)。259名乙脑病例中,死亡46人,病死率为17.8%。经多因素非条件logistic回归分析,年龄≥60岁[比值比(OR)=2.667,95%置信区间(CI):1.140~6.237],重型和极重型(OR=2.762、61.820,95%CI:1.053~7.091、5.149~742.239),患有慢性基础性疾病(OR=2.489,95%CI:1.038~5.964)是乙脑病例死亡的危险因素。结论陇南市乙脑病例死亡的影响因素有年龄、临床分型和患有慢性基础性疾病。因此要重点关注60岁以上、临床分型为重型和极重型、患有慢性基础性疾病的病例,加强重点人群乙脑疫苗的预防接种。

Objective To understand the influencing factors of death of epidemic Japanese encephalitis(EJE)cases in Longnan City of Gansu Province.Methods In the EJE Monitoring Information Report Management System of the Chinese Disease Prevention and Control Information System,data on EJE cases with onset from 2014 to 2018 and current address in Longnan City were derived.An"Individual Questionnaire of Epidemic Japanese Encephalitis in Longnan City"was designed,retrospective study was conducted on enrolled cases,their information on demographic data,consultation,onset,clinical classification,and chronic underlying diseases were collected,characteristics of EJE cases and death-related factors were analyzed.Results From 2014 to 2018,a total of 260 EJE cases were reported in Longnan City,and 259 cases completed the questionnaire.Among them,70 cases(27.0%)were aged≥60 years old,67 cases(25.9%)were severe and extremely severe,and 55 cases(21.2%)had chronic underlying diseases.Among 259 EJE cases,46 cases died,with a fatality rate of 17.8%.After multivariate unconditional logistic regression analysis,age≥60 years old[odds ratio(OR)=2.667,95%confidence interval(CI):1.140-6.237],severe and extremely severe(OR=2.762,61.820,95%CI:1.053-7.091,5.149-742.239),and chronic underlying diseases(OR=2.489,95%CI:1.038-5.964)were risk factors for death in EJE cases.Conclusions The influencing factors of death of EJE cases in Longnan City are age,clinical classification and chronic underlying diseases.Therefore,we should focus on patients over 60 years old,clinically classified as severe or extremely severe,and suffering from chronic underlying diseases,and strengthen the immunization of EJE vaccine for key populations.