Epidemiological investigation and clinical symptom analysis of influenza among children in a hospital of Bengbu City from 2018 to 2019
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摘要:
目的 分析儿童流行性感冒的流行病学特征及临床症状,为流感的防治提供依据。 方法 选取2018年1月—2019年12月期间蚌埠市第一人民医院确诊为流行性感冒并住院治疗的儿童528例作为研究对象,回顾并统计患儿的病史资料,分析其流行病学特征、临床症状和实验室检查,并进行统计学分析。 结果 528例流感患儿中,甲型流感(甲流)占21.2%,乙型流感(乙流)占55.5%,甲型流感合并乙型流感(甲流+乙流)占23.3%;罹患流感的高峰年龄段为1~7岁儿童,7~14岁次之,0~1岁的婴幼儿最少,其中1~7岁儿童随年龄增长流感发病率逐渐升高,男童与女童发生率差异无统计学意义(P=0.326);儿童流感每年高发季节在11~12月份至次年3月份;高发年龄在3~7岁的学龄期儿童;甲流患儿发热、咽痛、腹泻、头痛等临床症状上较重,住院时间长,发热持续时间长,并发症多,白细胞、降钙素、C反应蛋白等检验指标升高明显(均P < 0.05)。 结论 流感呈季节性爆发;乙流患儿多于甲流和甲流合并乙流者;甲流患儿临床症状、脏器损害明显重于甲流混合乙流和乙流者;甲流住院时间、发热持续时间均长于乙流和混合感染者。 Abstract:Objective To analyse the epidemiological characteristics and clinical symptoms of influenza among children in a hospital of Bengbu City from 2018 to 2019 so as to provide basis for the prevention and treatment of influenza. Methods A total of 528 children diagnosed with influenza and hospitalised in the First People's Hospital in Bengbu from January 2018 to December 2019 were selected as the research objects. The medical history data of the children were reviewed and statistically analysed along with the epidemiological characteristics, clinical symptoms and laboratory tests. Results Among the 528 children with influenza, 21.3% had influenza A, 55.6% had influenza B and 23.1% had influenza A combined with influenza B. The peak age of influenza was 1-7 years old and 7-14 years old, and the lowest was among the 0-1 year old infants. Among them, the incidence rate of influenza increased with age, regardless of gender. No significant difference was noted in the incidence rate (P=0.326). The high incidence season of influenza among children was from November to December to March of the next year. The high incidence age of school-age children was 3-7 years old. The clinical symptoms of fever, sore throat, diarrhoea, headache and other clinical symptoms of children with influenza A were severe, the hospitalization time was long, the fever lasted for a long time and the complications were more. In addition, the test indexes of white blood cell, calcitonin and C-reactive protein were significantly increased (all P < 0.05). Conclusion The influenza outbreak of children in Bengbu City is seasonal. The number of patients with influenza B is more than those with influenza A and influenza A combined with influenza B. The clinical symptoms and organ damage of children with influenza A are significantly more serious than those with mixed influenza A and B. The hospitalization time and fever duration of children with influenza A are longer than those with influenza B and mixed infection. -
Key words:
- Influenza /
- Epidemiology /
- Clinical symptoms /
- Children
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表 1 3种亚型流感病毒分布情况[例(%)]
项目 例数 性别 年龄(岁) 地区分布 男 女 0~1 ~3 ~7 ~14 蚌埠市 非蚌埠市 甲流 112 61(54.5) 51(45.5) 14(12.5) 43(38.4) 33(29.5) 22(19.6) 79(70.5) 33(29.5) 乙流 293 151(51.5) 142(48.5) 35(11.9) 108(36.9) 88(30.0) 62(21.2) 229(78.2) 64(21.8) 甲流合并乙流 123 63(51.2) 60(48.8) 16(13.0) 48(39.0) 34(27.6) 25(20.4) 84(68.3) 39(31.7) χ2值 0.326 0.478 5.429 P值 0.849 0.998 0.066 表 2 3种不同流感亚型流感患儿感染后临床特征分析(x ±s)
项目 例数 临床症状[例(%)] 并发症[例(%)] 恢复情况[例(%)] 发热 咳嗽 咽痛 头痛 消化道症状 肌肉酸痛 肺部感染 心肌损害 肝功能损害 发热时间(h) 住院时间(d) 甲流 112 102(91.2) 89(79.5) 77(68.8) 81(72.3) 52(46.4) 39(34.8) 34(30.4) 31(27.7) 20(17.9) 98.00±8.98 9.20±0.77 乙流 293 156(53.2) 144(49.1) 122(41.6) 152(51.9) 124(42.3) 101(34.5) 86(29.4) 68(23.2) 42(14.3) 66.00±7.09b 5.40±1.01b 甲流合并乙流 123 56(45.5) 57(46.3) 48(39.0) 66(53.7) 32(26.0) 23(18.7) 19(15.4) 10(8.1) 8(6.5) 79.00±4.88bc 7.20±0.22bc 统计量 61.037a 34.854a 27.797a 14.365a 12.593a 11.137a 9.827a 16.317a 7.234a 68.112d 70.253d P值 < 0.001 < 0.001 < 0.001 0.001 0.002 0.004 0.007 < 0.001 0.027 < 0.001 < 0.001 项目 例数 病史[例(%)] 实验室检查 早产 营养不良 呼吸系统慢性炎症 WBC(×109/L) N(%) CRP(mg/L) PCT(μg/L) CK-MB(U/L) cTnI(ng/mL) 甲流 112 23(20.5) 15(13.4) 22(19.6) 14.55±1.02 65.77±7.08 25.33±2.87 0.78±0.12 31.07±5.89 0.14±0.02 乙流 293 43(14.7) 29(9.9) 48(16.4) 13.27±1.88b 59.12±6.88b 20.45±3.47b 0.60±0.09b 26.46±7.98b 0.09±0.01b 甲流合并乙流 123 11(8.9) 6(4.9) 10(8.1) 12.32±0.99bc 60.77±5.55bc 19.88±2.48bc 0.58±0.11bc 25.77±6.78bc 0.09±0.01bc 统计量 6.329a 6.356a 6.820a 7.615d 40.680d 11.390d 12.280d 19.520d 17.970d P值 0.042 0.042 0.033 0.001 < 0.001 0.001 0.001 < 0.001 < 0.001 注:a为χ2值;与甲流组比较,bP < 0.05;与乙流组比较,cP < 0.05;d为F值。 -
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