2017—2020年重庆市流行性感冒重症及死亡病例流行病学特征分析

doi:10.3969/j.issn.1672-2302.2023.05.007

摘要/Abstract

摘要：

目的分析重庆市流行性感冒（简称流感）重症、危重症和死亡病例的流行病学特征，为流感重症防控提供依据。方法以2017年1月—2020年12月中国疾病预防控制信息系统中报告的重庆市流感重症、危重症及死亡病例为研究对象，收集相关资料，对其三间分布、既往病史及临床表现进行描述流行病学分析。结果 2017—2020年，重庆市共报告流感重症、危重症和死亡病例164例，发病时间集中于每年12月至次年3月，病原类型以甲型流感病毒为主（157例，占95.73%）。人群分布中，男性111例，女性53例，年龄以60~69岁组占比最高（34例，占20.73%），职业以农民占比最高（56例，占34.15%）。164例病例分布在重庆市19个县（区），报告数居前三位的县（区）为渝中区（101例）、垫江县（11例）及南岸区（6例）。164例病例中有既往病史的占58.54%（96/164），临床表现主要为咳嗽（159例）、异常呼吸音（134例）及发热（129例），并发症以肺炎最为常见（134例，占81.71%）。结论重庆市流感重症及死亡病例高发季为冬春季，主要病原类型为甲型流感病毒，流感重症病例以老年、男性人群居多，提示应提高流感疫苗接种率，同时关注高风险人群病情进展变化。

关键词: 流行性感冒, 重症病例, 流行特征, 重庆市

Abstract:

Objective To analyze the epidemiological characteristics of severe, critical and fatal cases of influenza in Chongqing Municipality for evidences for prevention and control of severe influenza. Methods The data of severe, critical and fatal cases of influenza reported in Chongqing Municipality were retrieved from 2017 to 2020 via the China Disease Prevention and Control Information System, and analyzed using descriptive epidemiology pertinent to the distribution of time, region and population as well as the past medical history of the patients and clinical manifestations of the infection. Results A total of 164 severe, critical and fatal cases of influenza were reported from 2017 to 2020 in Chongqing Municipality. The infection was most seen from December to March of the following year. Influenza A virus was the dominant virus (n=157 cases, 95.73%). By population distribution, 111 were males and 53 females. The infection most occurred in patients aged 60-69 years (n=34 cases, 20.73%), and farmers (n=56 cases, 34.15%). The 164 cases were distributed in 19 counties/districts, and the most reported was in Yuzhong District (n=101 cases), Dianjiang County (n=11 cases) and Nan'an District (n=6 cases). 58.54% (96/164) of the 164 cases had previous medical history. The main clinical manifestations were cough (n=159 cases), abnormal breath sounds (n=134 cases) and fever (n=129 cases). The most common complication was pneumonia (n=134 cases, 81.71%). Conclusion The high incidence of severe influenza and death in Chongqing generally occurs winter and spring seasons, with influenza A virus being the major pathogen. The severe infection is relatively higher in elderly and males. The findings suggest that the influenza vaccination rate should be increased, and attention should be paid to the progression of the disease among the high-risk groups.

Key words: Influenza, Severe cases, Epidemiological characteristics, Chongqing Municipality

中图分类号:

R511.7

熊宇, 漆莉, 李勤, 李柏松, 王菊. 2017—2020年重庆市流行性感冒重症及死亡病例流行病学特征分析[J]. 热带病与寄生虫学, 2023, 21(5): 273-277,286.

XIONG Yu, QI Li, LI Qin, LI Baisong, WANG Ju. Analysis on the epidemiological characteristics of severe and fatal cases of influenza in Chongqing from 2017 to 2020[J]. Journal of Tropical Diseases and Parasitology, 2023, 21(5): 273-277,286.

图/表 5

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表4

2017—2020年重庆市流感重症、危重症和死亡病例既往病史及临床信息比较

特征	重症病例（n=49）		危重症病例（n=79）		死亡病例（n=36）		合计（n=164）		χ²值	P值
特征	病例数（例）	构成比（%）	病例数（例）	构成比（%）	病例数（例）	构成比（%）	病例数（例）	构成比（%）	χ²值	P值
既往病史
慢性呼吸系统疾病	7	14.29	22	27.85	5	13.89	34	20.73	4.70	0.095
心血管疾病	8	16.33	20	25.32	12	33.33	40	24.39	3.33	0.190
代谢性疾病	5	10.20	7	8.86	9	25.00	21	12.80	6.19	0.045
慢性肝/肾病	5	10.20	9	11.39	4	11.11	18	10.98	0.05	0.978
免疫抑制状态*	10	20.41	6	7.59	1	2.78	17	10.37	8.20	0.017
临床表现
发热（≥38 $℃$ ）	37	75.51	66	83.54	26	72.22	129	78.66	2.30	0.316
咳嗽	47	95.92	76	96.20	36	100.00	159	96.95	1.50	0.482
咽痛	20	40.82	27	34.18	16	44.44	63	38.41	1.27	0.529
气短或呼吸困难	16	32.65	70	88.61	29	80.56	115	70.12	47.59	<0.001
气促	25	51.02	63	79.75	35	97.22	123	75.00	25.46	<0.001
异常呼吸音	33	67.35	71	89.87	30	83.33	134	81.71	10.35	0.006
并发症
肺炎	27	55.10	72	91.14	35	97.22	134	81.71	33.71	<0.001
呼吸衰竭	0	0	78	98.73	33	91.67	111	67.68	146.91	<0.001
急性呼吸窘迫综合征	7	14.29	40	50.63	25	69.44	72	43.90	28.44	<0.001
心力衰竭	1	2.04	18	22.78	15	41.67	34	20.73	20.22	<0.001
肾功能不全	1	2.04	11	13.92	17	47.22	29	17.68	30.58	<0.001
肝功能不全	5	10.20	26	32.91	18	50.00	49	29.88	16.36	<0.001
弥漫性血管内凝血	7	14.29	8	10.13	3	8.33	18	10.98	0.87	0.649
感染中毒性休克	0	0	7	8.86	13	36.11	20	12.20	26.86	<0.001

表4

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