2018-2021年北京市石景山区哨点医院疱疹性咽峡炎监测结果分析

Analysis of herpangina surveillance results in sentinel hospitals of Shijingshan District of Beijing from 2018 to 2021

目的 掌握北京市石景山区疱疹性咽峡炎流行病学特征、临床特点和病原构成变化趋势。方法 汇总2018-2021年北京市石景山区哨点医院首次就诊的疱疹性咽峡炎病例临床资料和集体单位聚集性疫情资料,并采集患儿咽拭子样本使用荧光定量PCR检测,监测结果用Excel 2013软件进行描述性统计,临床和流行特征分析采用SPSS 17.0软件统计进行统计学分析。计数资料表示为率(%)的形式,率的比较用χ2检验或精确概率法,检验水准ɑ=0.05。结果 2018-2021年石景山区哨点医院共报告疱疹性咽峡炎病例2 990例,占就诊比例115.56/万,发病高峰在4至10月份,年龄主要分布在0~5岁。采集疱疹性咽峡炎合格咽拭子标本230份,检出肠道病毒阳性50份,检出率为21.74%。不同年份疱疹性咽峡炎病原构成不同,但各年总检出率差异无统计学意义(χ^(2)=3.315,P=0.346)。是否发热(OR=2.278,95%CI:1.038~5.000,P=0.036),标本来源(OR=7.739,95%CI:1.375~43.569,P=0.007)和季节(OR=34.483,95%CI:4.566~250.000,P<0.001)是疱疹性咽峡炎检出的危险因素,发病就诊时间间隔(采样时间)是疱疹性咽峡炎检出的保护因素(OR=0.377,95%CI:0.108~1.318,P=0.006)。结论 2018-2021年北京市石景山区疱疹性咽峡炎病原主要是CV-A6和肠道病毒未分型,建议尽早制定诊疗和防控的指导性文件,并持续开展监测工作。

Objective To understand the epidemiological characteristics,clinical characteristics and the changing trend of pathogenic composition of herpangina in Shijingshan District of Beijing.Methods The clinical data of herpetic angina cases who visited the hospitals for the first time and thecluster epidemic dataof collective units were summarized of the sentinel hospitals of Shijingshan District,Beijing from 2018to 2021.Throat swab samples of the childrenwere collected for fluorescence quantitative PCR(polymerase chain reaction)detection,and descriptive statisticsofmonitoring results were performed by Excel 2013.Clinical and epidemiological characteristics were analyzed by SPSSS 17.0 statistical software.The count data were expressed in the form of rate(%).Rates were compared by Chi-square test or exact probability method.And the test level was α=0.05.Results A total of 2990 cases of herpangina were reported in sentinel hospitals of Shijingshan District from 2018 to 2021,accounting for 115.56/10*patients.The peak of incidence was between April and October.Most of the cases were 0-5 years old.A total of 230 qualified throat swab specimens of herpetic angina were collected,and 50 were positive for enterovirus,with a detection rate of 21.74%.The pathogen composition of herpetic angina was different in different years,but there was no significant difference in the total detection rate of each year(χ^(2)=3.315,P=0.346).Whether had a fever(OR=2.278,95%CI:1.038-5.000,P=0.036),source of specimens(OR=7.739,95%CI:1.375-43.569,P=0.007)and season(OR=34.483,95%CI:4.566-250.000,P<0.001)were risk factors for detection of herpetic angina.The time interval between diagnosis and treatment(sampling time)was a protective factor for detection of herpetic angina(OR=0.377,95%CI:0.108-1.318,P=0.006).Conclusions Coxsackievirus A6(CV-A6)and other untyped enterovirus were the main pathogens of herpangina in Shijingshan District of Beijing from 2018 to 2021.It is suggested to formulate guidelines for diagnosis,treatment,prevention and controal ssoon as possible,and carry out monitoring work continuously.