中华流行病学杂志
中華流行病學雜誌
중화류행병학잡지
CHINESE JOURNAL OF EPIDEMIOLOGY
2012年
4期
404-408
,共5页
徐翠玲%袁帆%陈敏%孙闪华%史景红%汪立杰%陈涛%杨静%向妮娟%张彦平%王世文%舒跃龙
徐翠玲%袁帆%陳敏%孫閃華%史景紅%汪立傑%陳濤%楊靜%嚮妮娟%張彥平%王世文%舒躍龍
서취령%원범%진민%손섬화%사경홍%왕립걸%진도%양정%향니연%장언평%왕세문%서약룡
甲型H1N1流感%肺炎
甲型H1N1流感%肺炎
갑형H1N1류감%폐염
Influenza A(H1N1 )%Pneumonia
目的 描述2009-2010年中国＜18岁人群甲型H1N1流感(甲流)相关肺炎住院病例的临床和流行病学特征,分析并发肺炎的危险因素.方法 对2009年9月1日至2010年7月4日中国“甲型H1N1流感信息管理系统”甲流住院病例(＜18岁)个案数据进行分析,描述其人口学、临床治疗、并发症、慢性基础性疾病等特征,分为并发与未并发肺炎2组进行单因素和多因素logistic分析.结果 共得到4240份甲流相关住院病例个案数据,其中4107例有“是否并发肺炎”方面的信息[2289例(55.7％)并发肺炎].甲流相关肺炎住院病例年龄中位数低于未并发肺炎者(4.9:13.1,P＜0.0001),且出现呼吸窘迫综合征、呼吸衰竭、需要ICU治疗、需要机械通气治疗以及出现死亡的风险均显著增加(P＜0.000l).多因素分析显示,与5～17岁人群相比,＜6月龄(OR=7.08,95％CI:4.15～ 12.06)、6～23月龄(aOR=8.26,95％CI:6.10～11.20)及2～4岁(aOR=9.53,95％CI:7.39～ 12.29)甲流相关住院病例并发肺炎的危险显著增高；哮喘(OR=12.19,95％ CI:5.18～28.72)、心血管疾病(OR=5.19,95％CI:1.94 ～ 13.90)、慢性肾脏疾病(OR=2.14,95％ CI:1.02～4.53)、慢性肝脏疾病(OR=5.26,95％CI:1.40～ 19.81)及过敏(OR=2.54,95％ CI:1.64～3.93)是＜18岁人群甲流住院病例并发肺炎的危险因素；与发病到抗病毒药物治疗的时间间隔不超过2d相比,时间间隔3～4d(OR=1.85,95％CI:1.45～2.36,P＜0.0001)、超过4d(OR=2.91,95％CI:2.29 ～ 3.71,P＜0.0001)显著增加并发肺炎的危险.结论 甲流相关住院病例并发肺炎的比例很高.与未并发肺炎者相比,甲流相关肺炎住院病例的病程更长和转归较差.
目的 描述2009-2010年中國＜18歲人群甲型H1N1流感(甲流)相關肺炎住院病例的臨床和流行病學特徵,分析併髮肺炎的危險因素.方法 對2009年9月1日至2010年7月4日中國“甲型H1N1流感信息管理繫統”甲流住院病例(＜18歲)箇案數據進行分析,描述其人口學、臨床治療、併髮癥、慢性基礎性疾病等特徵,分為併髮與未併髮肺炎2組進行單因素和多因素logistic分析.結果 共得到4240份甲流相關住院病例箇案數據,其中4107例有“是否併髮肺炎”方麵的信息[2289例(55.7％)併髮肺炎].甲流相關肺炎住院病例年齡中位數低于未併髮肺炎者(4.9:13.1,P＜0.0001),且齣現呼吸窘迫綜閤徵、呼吸衰竭、需要ICU治療、需要機械通氣治療以及齣現死亡的風險均顯著增加(P＜0.000l).多因素分析顯示,與5～17歲人群相比,＜6月齡(OR=7.08,95％CI:4.15～ 12.06)、6～23月齡(aOR=8.26,95％CI:6.10～11.20)及2～4歲(aOR=9.53,95％CI:7.39～ 12.29)甲流相關住院病例併髮肺炎的危險顯著增高；哮喘(OR=12.19,95％ CI:5.18～28.72)、心血管疾病(OR=5.19,95％CI:1.94 ～ 13.90)、慢性腎髒疾病(OR=2.14,95％ CI:1.02～4.53)、慢性肝髒疾病(OR=5.26,95％CI:1.40～ 19.81)及過敏(OR=2.54,95％ CI:1.64～3.93)是＜18歲人群甲流住院病例併髮肺炎的危險因素；與髮病到抗病毒藥物治療的時間間隔不超過2d相比,時間間隔3～4d(OR=1.85,95％CI:1.45～2.36,P＜0.0001)、超過4d(OR=2.91,95％CI:2.29 ～ 3.71,P＜0.0001)顯著增加併髮肺炎的危險.結論 甲流相關住院病例併髮肺炎的比例很高.與未併髮肺炎者相比,甲流相關肺炎住院病例的病程更長和轉歸較差.
목적 묘술2009-2010년중국＜18세인군갑형H1N1류감(갑류)상관폐염주원병례적림상화류행병학특정,분석병발폐염적위험인소.방법 대2009년9월1일지2010년7월4일중국“갑형H1N1류감신식관리계통”갑류주원병례(＜18세)개안수거진행분석,묘술기인구학、림상치료、병발증、만성기출성질병등특정,분위병발여미병발폐염2조진행단인소화다인소logistic분석.결과 공득도4240빈갑류상관주원병례개안수거,기중4107례유“시부병발폐염”방면적신식[2289례(55.7％)병발폐염].갑류상관폐염주원병례년령중위수저우미병발폐염자(4.9:13.1,P＜0.0001),차출현호흡군박종합정、호흡쇠갈、수요ICU치료、수요궤계통기치료이급출현사망적풍험균현저증가(P＜0.000l).다인소분석현시,여5～17세인군상비,＜6월령(OR=7.08,95％CI:4.15～ 12.06)、6～23월령(aOR=8.26,95％CI:6.10～11.20)급2～4세(aOR=9.53,95％CI:7.39～ 12.29)갑류상관주원병례병발폐염적위험현저증고；효천(OR=12.19,95％ CI:5.18～28.72)、심혈관질병(OR=5.19,95％CI:1.94 ～ 13.90)、만성신장질병(OR=2.14,95％ CI:1.02～4.53)、만성간장질병(OR=5.26,95％CI:1.40～ 19.81)급과민(OR=2.54,95％ CI:1.64～3.93)시＜18세인군갑류주원병례병발폐염적위험인소；여발병도항병독약물치료적시간간격불초과2d상비,시간간격3～4d(OR=1.85,95％CI:1.45～2.36,P＜0.0001)、초과4d(OR=2.91,95％CI:2.29 ～ 3.71,P＜0.0001)현저증가병발폐염적위험.결론 갑류상관주원병례병발폐염적비례흔고.여미병발폐염자상비,갑류상관폐염주원병례적병정경장화전귀교차.
Objective To describe the epidemiological and clinical features of hospitalized people less than 18 years old with influenza A (H1N1)-associated pneumonia and associated risk factors.Methods Through Chinese Reporting System of Influenza A (H 1 N1 ),children aged under 18 years who were hospitalized with laboratory confirmed influenza A (H1N1),case report forms and related information on pneumonia were collected between 1 September 2009 and 4 July 2010.Epidemiological and clinical characteristics including demographics,underlying chronic diseases,treatment,complications and clinical outcome etc.were described.Hospitalized children with pneumonia were compared with those without the above mentioned features,through the univariate and multivariate analysis.Results There were 4240 influenza A (H1N1)-associated hospitalized children with case report forms identified.Of the 4107 influenza A (H1N1) -associated hospitalized children with related information on pneumonia shown in the case report forms,2289 (55.7％) of them had pneumonia.Hospitalized children with influenza A (H1N 1 ) -associated pneumonia had a younger median age (4.9year old),when compared with those without pneumonia (13.1 year old,P＜ 0.0001 ).When compared with the hospitalized children without pneumonia,those hospitalized children with pneumonia were more likely to require intensive care unit care,using mechanical ventilation epuipmentto develop ARDS,respiratory failure or leading to death.Data from multivariate analysis showed that children aged ＜6months(OR=7.08,95％CI:4.15-12.06) between 6 and 23 months(aOR=8.26,95％CI:6.10-11.20) or between 2 to 4 year old (aOR=9.53,95％CI:7.39-12.29) were more likely to develop pneumonia than children aged 5 to 17.Factors as having asthma (OR=12.19,95％ CI:5.18-28.72),cardiovascular disease (OR=5.19,95％ CI:1.94-13.90),chronic renal diseases (OR=2.14,95％ CI:1.02-4.53),chronic hepatic diseases ( OR =5.26,95％ CI:1.40-19.81 ) and allergy (OR=2.54,95％ CI:1.64-3.93 )were significantly associated with influenza A (H1N1) -associated pneumonia.Risk of complication with pneumonia had an increase when oseltamivir treatment was initiated ＞2 days after the onset of illness.Conclusion Pneumonia was a common complication among children hospitalized with influenza A (H1N1).Hospitalized children with influenza A (H1N1)-associated pneumonia were more likely to develop either severe clinical courses or outcomes than those without pneumonia.
