摘要
目的总结儿童麻疹发病特征。方法回顾性分析2008年1月至2017年12月于首都儿科研究所附属儿童医院隔离门诊就诊和病房住院的麻疹病例的临床资料,对每年确诊病例总数、年龄、性别、疫苗接种情况、临床发病特点及并发症进行统计,根据是否接种麻疹疫苗进行分组比较。结果 10年间共确诊麻疹病例274例,其中男156例,女118例,发病年龄0～16岁,以3岁以下儿童为主(236/274,86.1%)。每年3～5月是麻疹高发月份。未接种麻疹疫苗228例(83.2%),其中未达麻疹疫苗初免年龄(<8个月)的患儿105例(46.1%),接种麻疹疫苗46例。全部病例均有不同程度的发热及皮疹,未接种疫苗组符合典型麻疹出疹顺序的患儿比例高于接种疫苗组(68.0%vs. 52.2%,χ~2=4.223,P<0.05);未接种疫苗组口腔麻疹黏膜斑发生率高于接种疫苗组(71.5%vs. 47.8%,χ~2=9.775,P<0.01);咳嗽为最常见的呼吸道症状,未接种疫苗组咳嗽发生率高于接种疫苗组(92.1%vs. 69.6,χ~2=18.853,P<0.01),腹泻发生率也高于接种疫苗组(37.7%vs. 21.7%,χ~2=4.295,P<0.05)。呼吸道并发症以支气管炎及肺炎常见,支气管炎发生率未接种疫苗组高于接种疫苗组(25.9%vs. 4.3%,χ~2=10.252,P<0.01),肺炎发生率也高于接种疫苗组(30.7%vs. 10.9%,χ~2=7.573,P<0.01)。结论儿童麻疹发病以未接种麻疹疫苗的儿童为主,接种疫苗的患儿临床症状趋于不典型,未接种麻疹疫苗患儿更常发生呼吸道并发症,及时接种麻疹疫苗可降低麻疹发病率,利于麻疹防控。
Objective To summarize the clinical characteristics of measles in children. Methods A retrospective analysis of clinical data of measles cases in January 2008 to December 2017 was carried out, the age, gender, vaccination status, clinical characteristics and complications were counted. Results A total of 274 cases of measles were confirmed during 10 years. The ratio of males to females was 1.32: l,the majority were children under 3 years old (236/274,86.1%). There was a high incidence of measles in March to May. A total of 228 cases were not vaccinated against measles and 46 cases were vaccinated, among them, 105 children did not reach the initial immunization age (< 8 months) for measles vaccine. There were various levels of fever and rash. The proportion of the unvaccinated children who conformed to the typical sequence of measles eruption was higher than that of the vaccinated group (68.0% vs.52.2%, P< 0.05), the incidence of Koplik spots in the unvaccinated group was higher than that of the vaccinated group (71.5% vs. 47.8%, P < 0.01). Cough was the most common respiratory symptom, the incidence of the unvaccinated group was higher than that of the vaccinated group (92.1% vs. 69.6%, P < 0.01), and the incidence of diarrhea in the unvaccinated group was higher than that in the vaccinated group (37.7% vs. 21.7%, P < 0.05). The incidences of bronchitis and pneumonia in the unvaccinated group were higher than those in the vaccinated groups (25.9% vs. 4.3%, P < 0.01;30.7% vs. 10.9%, P < 0.01). Conclusions The majority of measles patients are children who have not been vaccinated against measles. The clinical symptoms of children vaccinated against measles tend to be atypical, and the children unvaccinated are more likely to have respiratory complications. Timely vaccination against measles can reduce the incidence of measles, which is conducive to the prevention and control of measles.
作者
黄辉
邓莉
朱汝南
Huang Hui;Deng Li;Zhu Runan(Department of Infectious Diseases, Affiliated Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China)
出处
《北京医学》
CAS
2019年第3期194-197,共4页
Beijing Medical Journal
关键词
儿童
麻疹
临床表现
麻疹疫苗
child
measles
clinical manifestation
measles vaccine
