北京朝阳区2009年甲型H1N1流感重症病例流行病学特征

目的 了解北京市朝阳区甲型H1N1流感重症和危重病例的流行病学特征，探讨甲型H1N1流感重症和危重病例转归的可能影响因素。方法通过朝阳区甲型H1N1流感信息管理系统收集朝阳区甲型H1N1流感重症和危重病例相关信息并进行流行病学分析。建立多因素Logistic回归模型，分析疾病转归和各种因素的关系。结果2009年朝阳区甲型H1N1流感重症和危重病例共150例，罹患率为5．53／10万，男性略高于女性（×冬5．494，P〈0．05）；5岁及以下年龄组的罹患率最高，为26．67／10万，其次为60岁以上年龄组；城市居民所占比例略高（58％）；危重症病例就诊间隔在1-2d的居多，占70％，有慢性基础性疾病者占56％。Logistic回归分析显示，甲型H1N1流感病例中，慢性肺部疾病及心血管疾病可能提高死亡风险。OR值分别为10．628和8．063。结论男性、5岁以下婴幼儿及60岁以上老年人为罹患甲型H1N1流感重症和危重病例的高风险人群；伴心血管疾病及慢性肺部疾病等因素可能提高甲型H1N1流感重症和危重病例的死亡风险。

Epidemiological features and risk factors of severe cases of influenza A ( H1N1 )in Chaoyang District of Beijing in 2009

Objective To describe the epidemiological features of severe cases of influenza A （H1N1）in Chaoyang District of Beijing in 2009. Methods The dala of severe cases of influenza A （H1N1） in Chaoyang District in 2009 were collected from information management system of Chaoyang District and analyzed with the multi-factor Logistic regression analysis. Results There were 150 severe cases from May to December in Chaoyang District and the incidence was 5.53/100 000. The incidence of male severe cases was higher than female （X^2=5.494,P〈 0.05）. The highest incidence was 26.67/100000 occurred among people aged below 5 years old and followed in those aged above 60 yems old. The proportion of urban residents was the highest（58%）. 70% severe cases came to the hospital 1-2 days after disease onset. Multifactor logistic regression analysis showed that the variables including chronic pulmonary condition and （OR=lO.628,P〈O.O5）and cardiovascular diseases （OR=8,063,P〈O.05）were significantly associated with the clinical outcome. Conclusion Male people aged below 5 years old and above 60 years old are the highly risk population of acquiring severe and critical influenza A（H1NI ）,while（pulmonary or cardiovascular underlying conditions of the patients with influenza A（H1N1 ）may aggravate or increase the risk of death.