流感暴发期间5447例成人流感样病例的流感病毒检测结果与分布特征

Detection and distribution characteristics of flu viruses in 5 447 cases of adult influenza-like illness during flu outbreaks

  • 摘要: 目的 探讨2017-2018年冬春时期流感流行季节北京地区流感的类型构成与分布特征。方法 收集某三级甲等医院流行期间5 447例成人流感样病例(ILI),采用甲型/乙型流感抗原检测试剂盒(胶体金法)进行流感快速筛查,Real-time RT-PCR检测核酸,确诊流感及其类型,应用SPSS 19.0统计软件包进行数据分析。结果 ILI流感检出率22.87%,不同性别ILI流感检出率的差异无统计学意义(u=1.34,P=0.207),≥60岁老人ILI流感检出率低于中青年(P<0.05);在确诊病例中,甲流、乙流和混合流感分别占24.31%、63.53%和12.16%;甲流、乙流和混合流感的时间分布特征类似,均呈M型双峰曲线,乙流流行强度最强,峰期较甲流滞后约1周,混合流感流行强度最低,峰期出现在甲流乙流峰期后;不同性别患者各类型流感的构成比例相似,构成差异无统计学意义(P=0.324);不同年龄患者各类型流感的构成无统计学意义(P=0.021),老年人甲流的比例上升,达29.83%;患者中80.77%为轻症病例,11.24%合并支气管炎,7.99%合并肺炎,不同类型及性别流感患者下呼吸道感染发病率差异无统计学意义,老年人并发下呼吸道感染多于中青年(P<0.05)。结论 本地区本次冬春季的流感流行呈现出一些新的特征,需要采取针对性措施,保护老年患者,更新免疫接种策略,强化人群免疫屏障。

     

    Abstract: OBJECTIVE To explore the classification and distribution features of flu in Beijing during the flu season of the winter and the spring from 2017 to 2018. METHODS A total of 5 447 cases of adult influenza-like illness (ILI) in a "AAA" hospital during the flu outbreak were gathered. Rapid influenza screening was conducted using antigen test kit for Flu A/B (colloidal gold method), and nucleic acid was detected by real-time RT-PCR to confirm influenza and its type. SPSS19.0 statistical package was used for data analysis. RESULTS The positive rate of flu in ILI was 22.87%, and the difference between the positive rates of males and females was not significant (u=1.34, P=0.207). The detection rate in the elderly (≥60 years old) was significantly lower than that of the young and middle-aged people(P<0.05). In the confirmed cases, flu A, flu B and mixed flu accounted for 24.31%, 63.53% and 12.16%, respectively. The time distributions of flu A, flu B and the mixed were similar, all showing M-shaped bimodal curve. Flu B had the highest epidemic intensity with peaks about one week later than flu A, whereas the epidemic intensity of the mixed flu was the lowest with peaks after flu A and flu B. Males and females had similar ratio of the three types of flu, the difference of which was not significant (P=0.324). The ratio of different types of flu in patients of different ages was significantly different (P=0.021), and the ratio of flu A in the elderly increased remarkably at 29.83%. Among patients with flu, 80.77% were mild cases, 11.24% were complicated with bronchitis, and 7.99% were complicated with pneumonia. No significant difference was found in the incidence of lower respiratory tract infections among different types of flu and different genders. However, the incidence in the elderly was significantly higher than those of the young and middle-aged people (P<0.05). CONCLUSION The flu outbreak in this region during the winter and the spring presents some new features. It is necessary to take targeted measures to protect the elderly patients, update vaccination strategies and strengthen the public immunity barrier against flu.

     

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