摘要
目的分析甲型H1N1流感重症病例死亡的危险因素,为甲流的防控工作提供参考依据。方法采用病例对照研究设计,选择天津市2009—2010年的17例甲型H1N1死亡病例作为病例组,同时选择同一就诊医院、相同发病月份的重症或危重病例作为对照组与死亡病例进行1∶4匹配,对病例一般情况、既往病史及用药治疗情况等因素进行单因素及多因素条件logistic回归分析。结果共调查病例组17人、对照组68人。两组男女比例分别为1.43∶1和2.40∶1;孕妇所占比例分别为23.53%(4/17)和7.35%(5/68);患慢性基础性疾病比例分别为47.06%(8/17)和50.00%(34/68)。发病至住院的时间间隔中位数(范围)分别为5.0(2.0～7.0)d和3.0(0～5.0)d、患慢性基础性疾病病种数中位数(范围)分别为2(1～3)种和1(0～2)种。经多变量logistic回归分析,妊娠(OR=10.896)、发病至住院的时间间隔(OR=1.686)、患慢性基础性疾病病种数(OR=3.505)是住院患者死亡的危险因素。结论患流感样症状的人群应及时就诊,同时医院应加强对重症病例的早期识别和治疗,以降低甲型H1N1流感的病死率。
Objective To evaluate the risk factors of death in severe and critical patients with in- fluenza A （ H1N1 ） . Methods A 1 ： 4 matched case-control study was conducted. Death patients with in- fluenza A（ H1N1 ） were selected in Tianjin City from 2009 to 2010. Cases of other severe or critical illness in the same hospital and at the same onset month were selected as control. Factors concerning demography, chronic disease history and treatment process in death and severe or critical patients with influenza A （H1N1） were analyzed by conditional univariate and multivariate logistic regression. Results Seventeen cases in study group and 68 in control group were investigated. Between study and control groups, sex rati- os were 1.43： land 2.40： 1, proportion of pregnant were 23.53% （4/17）and 7.35% （5/68）, proportion of chronic disease history were 47.06% （8/17） and 50.00% （34/68）, the median of interval between on- set and hospitalization were 5.0 （ 2. 0 - 7.0 ） and 3.0 （ 0 - 5.0 ） days, the median of numbers of chronic co- morbid illness were 2 （ 1 - 3 ） and 1 （0 - 2）, respectively. Pregnant （ OR = 10. 896）, interval between onset and hospitalization （ OR = 1. 686）, and numbers of chronic comorbid illness （ OR = 3. 505 ） were identified as the risk factors in the final multivariate logistic model. Conclusion Individuals with risk factors for se- vere cases of influenza A （H1NI） should receive early treatment and hospital should recognize the patients with risk factors in the early stage for reducing the mortality of patients with influenza A （H1N1）.
出处
《华南预防医学》
2012年第1期6-9,13,共5页
South China Journal of Preventive Medicine
基金
天津市卫生局科技基金项目(2009KZ43)
