凉山地区125例小于8月龄婴儿麻疹流行病学及临床特征分析

Analysis of epidemiological and clinical characteristics of measles in 125 cases of infant aged below 8 month in liangshan area

目的 :探讨凉山地区小于8月龄婴儿麻疹流行特征及临床特点,以及彝、汉民族间的差异,为制定消除麻疹策略提供依据。方法 :对2014年～2016年在凉山州第一人民医院住院的125例小于8月龄的婴儿麻疹患者进行回顾性分析。对彝族及汉族婴儿麻疹临床特征进行比较,构成比较采用χ2检验。结果 :凉山地区小于8月龄婴儿麻疹发病主要集中在4～8月龄,发病率为90.4%。麻疹流行时间集中在12月～次年2月,患者107例(占85.6%)。流行主要人群是凉山州本地的农村婴儿110例(占88.0%),本次流行受外来流动人口的影响小。约有67.2%婴儿母亲未接种过麻疹疫苗。彝、汉族婴儿麻疹患儿临床对比调查,黏膜斑特点、多系统并发症及麻疹抗体等指标具有统计学差异,其余临床指标的差异无统计学意义。结论 :凉山地区本次婴儿麻疹流行主要与婴儿母亲免疫覆盖率低、疫苗免疫原性下降、胎传抗体衰减等因素有关;控制8月龄内婴儿麻疹发病率应提高常规免疫接种率,开展育龄妇女等成人强化免疫,重视保护易感婴儿。应不断加大我州偏远山区的医疗投入,尤其需加强村民的健康教育工作。

Objective To explore the epidemiological characteristics of measles in infants aged below 8 months in Liangshan area and the clinical characteristics of measles in yi and Han nationality infants, in order to provide evidence for measleselimination strategy. Methods The investigation and analysis have been taken among 125 infants with measles aged below 8 months in the first people’s hospital of Liangshan from 2014 to 2016. A comparative study of clinical cases of measles in infants of yi and Han nationality was conducted, with the method of χ2 test in the comparison. Results The incidence of measles lies mainly in the age of 4~8 months old in infants aged below 8 months, which is 90.4 % in Liangshan area. The prevalence of measles was concentrated in December-February of the following year, 107 cases(85.6 %). The main crowd is the local rural infants in Liangshan(88 %), and this epidemic is hardly affected by the floating population. Some 67.2 % of the mothers have not been vaccinated against measles. The clinical comparative investigation of infants with measles in yi and Han nationality showed statistical difference in the characteristics of mucosal plaque, multiple system complications and measles antibody, the difference of other clinical indexes was not statistically significant. Conclusion The measles epidemic in Liangshan area is mainly re lated to the low immunization coverage rate, the decrease of immunogenicity of vaccine, the attenuation of fetal transmission antibody, etc. Improvement of the routine immunization rate should be taken to control the incidence of measles in infants of 8 months old, as well as the adult intensive immunization of women in childbearing age, and more attention to the protection of susceptible infants. The medical input in the remote mountainous areas of my state should be increased, especially the health education of villagers should be strengthened.