中华临床感染病杂志
中華臨床感染病雜誌
중화림상감염병잡지
Chinese Journal of Clinical Infectious Diseases
2015年
5期
419-424
,共6页
闫玉光%马玉梅%魏倪%张明香%韩白乙拉%王艳波%金春英%韩乐强%赵永祥%曹玉芝%方红%胡浩%刘铮
閆玉光%馬玉梅%魏倪%張明香%韓白乙拉%王豔波%金春英%韓樂彊%趙永祥%曹玉芝%方紅%鬍浩%劉錚
염옥광%마옥매%위예%장명향%한백을랍%왕염파%금춘영%한악강%조영상%조옥지%방홍%호호%류쟁
麻疹%流行特点%临床特征
痳疹%流行特點%臨床特徵
마진%류행특점%림상특정
Measles%Epidemic characteristics%Clinical characteristics
目的:比较2014年我国东北地区不同年龄组麻疹患者流行及临床特征差异。方法连续收集东北地区2014年1至6月10家传染病医院收治住院的麻疹患者的病例资料,将患者分为<16岁组和≥16岁组,对所有病例的流行病学、临床特征、治疗及转归情况进行回顾性分析。采用SPSS 17.0统计软件对数据进行比较。结果共收集到1401例麻疹患者,其中<16岁组402例,≥16岁999例。主要的临床表现有充血性斑丘疹(100.0%)、发热(84.58%)、咳嗽(85.80%)、科氏斑(73.23%)、咽充血(71.23%)、腹泻(43.97%)、咳痰(40.97%)、流泪(39.40%)和流涕(30.55%)。<16岁组患者科氏斑、咳痰、咽充血、腹泻的发生率低于≥16岁组患者,差异具有统计学意义(χ2=8.364、29.768、10.953和6.701,P<0.05或<0.01),但流涕的发生率高于≥16岁组患者,差异亦有统计学意义(χ2=6.703,P<0.05)。患者血常规、C-反应蛋白( CRP)、肝肾功能、电解质、心肌酶谱等指标存在异常,<16岁组外周血 WBC 升高或下降、PLT 和肌酸激酶同工酶升高分别为38例(9.45%)、105例(26.12%)、122例(30.35%)和279例(69.40%),均高于≥16岁组患者,分别为45例(4.5%)、202例(20.22%)、14例(1.40%)和347例(34.73%),差异具有统计学意义(χ2=12.593、5.830、274.033和139.385,P<0.05或<0.01);<16岁组患者丙氨酸转氨酶( ALT)、总胆红素水平( TBil)、肌酸激酶( CK)和CRP升高分别为70例(17.41%)、7例(1.74%)、38例(9.45%)和7例(1.74%),而白蛋白(Alb)、K+、Na+、Cl-下降,分别为214例(53.23%)、59例(14.68%)、45例(11.19%)和94例(23.38%),异常率均低于≥16岁组,分别为668例(66.87%)、89例(8.91%)、277例(27.73%)、714例(71.47)和268例(26.83%)、339例(33.93%)、642例(64.26%)、450例(45.05%),组间差异具有统计学意义(χ2=281.230、23.073、50.687、159.740和14.674、114.286、44.268、271.546,P<0.01)。喉炎和肺炎是麻疹患者的主要并发症,喉炎的发生率<16岁组为12.69%(51/402),≥16岁组为9.31%(93/999),X 线提示斑片影的发生率<16岁组72.89%(121/166),≥16岁组为59.55%(265/445),组间差异均具有统计学意义(χ2=3.545和9.249,P<0.05或P<0.01)。结论<16岁组与≥16岁组麻疹患者的临床特征存在差异,加强麻疹疫苗的基础免疫接种和成年麻疹疫苗复种能有效控制麻疹。
目的:比較2014年我國東北地區不同年齡組痳疹患者流行及臨床特徵差異。方法連續收集東北地區2014年1至6月10傢傳染病醫院收治住院的痳疹患者的病例資料,將患者分為<16歲組和≥16歲組,對所有病例的流行病學、臨床特徵、治療及轉歸情況進行迴顧性分析。採用SPSS 17.0統計軟件對數據進行比較。結果共收集到1401例痳疹患者,其中<16歲組402例,≥16歲999例。主要的臨床錶現有充血性斑丘疹(100.0%)、髮熱(84.58%)、咳嗽(85.80%)、科氏斑(73.23%)、嚥充血(71.23%)、腹瀉(43.97%)、咳痰(40.97%)、流淚(39.40%)和流涕(30.55%)。<16歲組患者科氏斑、咳痰、嚥充血、腹瀉的髮生率低于≥16歲組患者,差異具有統計學意義(χ2=8.364、29.768、10.953和6.701,P<0.05或<0.01),但流涕的髮生率高于≥16歲組患者,差異亦有統計學意義(χ2=6.703,P<0.05)。患者血常規、C-反應蛋白( CRP)、肝腎功能、電解質、心肌酶譜等指標存在異常,<16歲組外週血 WBC 升高或下降、PLT 和肌痠激酶同工酶升高分彆為38例(9.45%)、105例(26.12%)、122例(30.35%)和279例(69.40%),均高于≥16歲組患者,分彆為45例(4.5%)、202例(20.22%)、14例(1.40%)和347例(34.73%),差異具有統計學意義(χ2=12.593、5.830、274.033和139.385,P<0.05或<0.01);<16歲組患者丙氨痠轉氨酶( ALT)、總膽紅素水平( TBil)、肌痠激酶( CK)和CRP升高分彆為70例(17.41%)、7例(1.74%)、38例(9.45%)和7例(1.74%),而白蛋白(Alb)、K+、Na+、Cl-下降,分彆為214例(53.23%)、59例(14.68%)、45例(11.19%)和94例(23.38%),異常率均低于≥16歲組,分彆為668例(66.87%)、89例(8.91%)、277例(27.73%)、714例(71.47)和268例(26.83%)、339例(33.93%)、642例(64.26%)、450例(45.05%),組間差異具有統計學意義(χ2=281.230、23.073、50.687、159.740和14.674、114.286、44.268、271.546,P<0.01)。喉炎和肺炎是痳疹患者的主要併髮癥,喉炎的髮生率<16歲組為12.69%(51/402),≥16歲組為9.31%(93/999),X 線提示斑片影的髮生率<16歲組72.89%(121/166),≥16歲組為59.55%(265/445),組間差異均具有統計學意義(χ2=3.545和9.249,P<0.05或P<0.01)。結論<16歲組與≥16歲組痳疹患者的臨床特徵存在差異,加彊痳疹疫苗的基礎免疫接種和成年痳疹疫苗複種能有效控製痳疹。
목적:비교2014년아국동북지구불동년령조마진환자류행급림상특정차이。방법련속수집동북지구2014년1지6월10가전염병의원수치주원적마진환자적병례자료,장환자분위<16세조화≥16세조,대소유병례적류행병학、림상특정、치료급전귀정황진행회고성분석。채용SPSS 17.0통계연건대수거진행비교。결과공수집도1401례마진환자,기중<16세조402례,≥16세999례。주요적림상표현유충혈성반구진(100.0%)、발열(84.58%)、해수(85.80%)、과씨반(73.23%)、인충혈(71.23%)、복사(43.97%)、해담(40.97%)、류루(39.40%)화류체(30.55%)。<16세조환자과씨반、해담、인충혈、복사적발생솔저우≥16세조환자,차이구유통계학의의(χ2=8.364、29.768、10.953화6.701,P<0.05혹<0.01),단류체적발생솔고우≥16세조환자,차이역유통계학의의(χ2=6.703,P<0.05)。환자혈상규、C-반응단백( CRP)、간신공능、전해질、심기매보등지표존재이상,<16세조외주혈 WBC 승고혹하강、PLT 화기산격매동공매승고분별위38례(9.45%)、105례(26.12%)、122례(30.35%)화279례(69.40%),균고우≥16세조환자,분별위45례(4.5%)、202례(20.22%)、14례(1.40%)화347례(34.73%),차이구유통계학의의(χ2=12.593、5.830、274.033화139.385,P<0.05혹<0.01);<16세조환자병안산전안매( ALT)、총담홍소수평( TBil)、기산격매( CK)화CRP승고분별위70례(17.41%)、7례(1.74%)、38례(9.45%)화7례(1.74%),이백단백(Alb)、K+、Na+、Cl-하강,분별위214례(53.23%)、59례(14.68%)、45례(11.19%)화94례(23.38%),이상솔균저우≥16세조,분별위668례(66.87%)、89례(8.91%)、277례(27.73%)、714례(71.47)화268례(26.83%)、339례(33.93%)、642례(64.26%)、450례(45.05%),조간차이구유통계학의의(χ2=281.230、23.073、50.687、159.740화14.674、114.286、44.268、271.546,P<0.01)。후염화폐염시마진환자적주요병발증,후염적발생솔<16세조위12.69%(51/402),≥16세조위9.31%(93/999),X 선제시반편영적발생솔<16세조72.89%(121/166),≥16세조위59.55%(265/445),조간차이균구유통계학의의(χ2=3.545화9.249,P<0.05혹P<0.01)。결론<16세조여≥16세조마진환자적림상특정존재차이,가강마진역묘적기출면역접충화성년마진역묘복충능유효공제마진。
Objective To investigate the epidemiological and clinical characteristics of measles in patients of different age groups in Northeast China in 2014.Methods The clinical data of patients with measles in ten hospitals of infectious diseases in Northeast China from January 2014 to June 2014 were collected.Patients were divided into <16 age group and ≥16 age group, and the epidemiology , clinical characteristics, treatment and prognosis of all patients were retrospectively reviewed .SPSS 17.0 was used for data analysis.Results There were 1 401 patients with measles, in which 402 were <16-year old, and 999 were ≥16-year old.Clinical manifestations were mainly maculopapule (100.0%), fever (84.58%), cough (85.80%), Koplik’ s spot (73.23%), pharyngeal hyperemia (71.23%), diarrhea (43.97%), expectoration (40.97%), tears (39.40%) and runny nose (30.55%).The incidences of Koplik’s spot, sputum, pharyngeal hyperemia and diarrhea in <16 age group were lower than those in ≥16 age group (χ2 =8.364, 29.768, 10.953 and 6.701, P<0.05 or <0.01); while the incidence of runny nose was higher than that in ≥16 age group (χ2 =6.703, P<0.05).Abnormalities were found in blood routine examination, C-reactive protein (CRP), liver and kidney function, serum electrolyte levels, myocardial enzymes, and so on.Increasing in WBC, PLT and creatine kinase isoenzyme (CKMB), and decreasing in WBC were observed in 38(9.45%), 122(30.35%), 279(69.40%) and 105(26.12%), patients in <16 age group, which were higher than those in ≥16 age group [45(4.5%), 14(1.40%), 347(34.73%) and 202(20.22%)], and the differences were of statistical significance (χ2 =12.593, 274.033, 139.385 and 5.830, P<0.05 or P<0.01).Increasing in alanine aminotransferase (ALT), CRP, total bilirubin level (TBil), creatine kinase (CK), and decreasing in albumin (Alb), K+, Na+, Cl-were observed in 70(17.41%), 7(1.74%), 38(9.45%), 7(1.74%), and 214(53.23%), 59(14.68%), 45(11.19%), 94(23.38%) patients in <16 age group, which were lower than those in ≥16 age group [668(66.87%), 89(8.91%), 277(27.73%), 714(71.47), and 268(26.83%), 339(33.93%), 642(64.26%), 450 (45.05%)], and the differences were of statistical significance (χ2 =281.230, 23.073, 50.687, 159.740, and 14.674,114.286, 44.268, 271.546, P<0.01).Laryngitis and pneumonia were the most common complications.The incidence of laryngitis in <16 age group was 12.69% (51/402), which was higher than that in ≥16 years group (93/999, 9.31%,χ2 =3.545, P<0.05);while the incidence of spot shadows demonstrated by X-ray in <16 years group ( 72.89%, 121/166 ) was higher than that in ≥16 years group (265/445, 59.55%,χ2 =9.249, P<0.01).Conclusions There are differences in clinical features of measles in patients between <16 age group and ≥16 age group.Basic immunization in children and revaccination in adults should be enhanced to control the epidemics of measles .