2015—2019年宁波市0~36月龄婴幼儿癫痫发病的流行病学研究

目的: 描述浙江省宁波市0~36月龄婴幼儿癫痫发病的三间分布及其变化趋势。方法: 采用出生队列设计,回顾性收集2015—2019年宁波市全民健康信息平台中本地出生的婴幼儿,以平台内电子病历首次癫痫就诊作为新发病例。采用泊松分布估算癫痫发病密度及其95%CI。结果: 2015—2019年宁波市累计出生29.49万儿童,男性占51.92%,总人年59.53万,中位随访人年2.31年四分位距(interquartile range, IQR):1.90]。观察期间癫痫新发575例,总就诊人次2 599,平均就诊人次4.52,总发病密度96.59/10万人年(95%CI:88.85~104.82)。中位发病月龄13月龄(IQR:15),0~12月龄发病密度最高(102.18/10万人年),25~36月龄最低(89.68/10万人年),差异无统计学意义(P>0.05)。男性发病密度97.58/10万人年,女性95.53/10万人年,差异无统计学意义(P>0.05)。下辖10个区县中,奉化最高(130.54/10万人年,95%CI:94.47~175.83),宁海最低(66.44/10万人年,95%CI:47.02~91.19), 差异有统计学意义(P<0.05)。不同出生年份发病差异无统计学意义(P>0.05)。不同日历年0~12月龄发病密度差异有统计学意义(P_trend<0.05)。该年龄组下, 2015年发病密度最低(69.41/10万人年,95%CI:41.79~108.39), 2019年最高(225.61/10万人年,95%CI:186.10~271.03)。不同日历年13~24、25~36月龄发病密度差异无统计学意义(P>0.05)。结论: 2015—2019年宁波市0~36月龄婴幼儿癫痫发病密度整体较低,年龄组、性别、出生年份等发病密度差异均无统计学意义,0~12月龄婴幼儿发病密度随年份呈递增趋势。

Epidemiological study of infantile epilepsy incidence density among infants under 36 months of age in Ningbo City from 2015 to 2019

Objective: To describe the distribution and trend of infantile epilepsy among infants under 36 months in Ningbo, Zhejiang Province. Methods: Using the birth cohort design, we retrospectively collected the local born infants in Ningbo national health information platform from 2015 to 2019, and took the first visit of epilepsy in the electronic medical record of the platform as the new case. The incidence density and 95% confidence interval (CI) of epilepsy were estimated by Poisson distribution. Results: From 2015 to 2019, a total of 294 900 children were born in Ningbo, with male accounting for 51.92%. The total person-years of observation were 595 300, while the median follow-up person-years was 2.31 interquartile range (IQR): 1.90]. There were 575 new onset epilepsy patients during the whole observation period. The total number of visits was 2 599, with an average of 4.52. The total incidence density was 96.59/100 000 person-years (95%CI: 88.85-104.82). The median age of onset was 13 months (IQR: 15), 0-12 months old infants had the highest incidence density (102.18/100 000 person-years), 25-36 months old infants had the lowest incidence density (89.68/100 000 person-years), and the difference was not statistically significant (P>0.05). The incidence density of male was 97.58/100 000 person-years, female was 95.53/100 000 person-years, and the difference was not statistically significant (P>0.05). Fenghua was the highest (130.54/100 000 person-years, 95%CI: 94.47-175.83) and Ninghai was the lowest (66.44/100 000 person-years, 95%CI: 47.02-91.19), with significant difference (P<0.05). There was no significant difference in the incidence density in different birth years (P>0.05). There was significant difference in the incidence density between 0-12 months old infants in different calendar years (P_trend<0.05). In this age group, the incidence density was the lowest in 2015 (69.41/100 000 person-years, 95%CI: 41.79-108.39), and the highest in 2019 (225.61/100 000 person-years, 95%CI: 186.10-271.03). There was no significant difference in the incidence density between 13-24 and 25-36 months old infants in different calendar years (P>0.05). Conclusion: The incidence density of epilepsy in 0-36 months old infants in Ningbo City from 2015 to 2019 was low as a whole, and there was no difference in age group, gender, and year of birth. The incidence density of 0-12 months old infants increased with the year.