摘要
目的:探讨浙江省宁波市2015—2021年6岁以下儿童热性惊厥(febrile seizure,FS)发病的流行病学特征,分析新型冠状病毒感染对FS发病趋势的影响。方法:基于宁波区域卫生信息平台,利用预防接种登记信息建立动态队列,通过电子病历的中文诊断术语“热性惊厥”“发热惊厥”“发热&惊厥”等,以及国际疾病分类第10版(International Classification of Diseases 10th revision,ICD-10)编码(R56.0)识别FS病例,在观察期间内FS发作并首次就诊定义为新发病例,发作间隔大于7 d为复发病例。采用Poisson分布估算发病密度的95%置信区间(confidence interval,CI)。结果:2015年1月至2021年6月,累计纳入宁波市6岁以下儿童130.3万人,男性占52.87%,总随访人时为3765767.35人年,中位随访时间为2.83(1.55~4.00)年。研究期间共有12776例FS新发病例,男性多于女性,总发病密度为4.34(95%CI:4.27~4.40)/1000人年,复发率为21.63%。男性、出生于宁波、非流动儿童FS的发病密度较高。相比于乡村和城乡结合部,城区FS的发病密度更高,且各区县间发病密度不同。儿童18~23月龄为发病密度高峰[8.42(95%CI:8.11~8.74)/1000人年];2015—2019年,发病密度逐年升高(P_(trend)<0.001),最高为5.62(95%CI:5.43~5.81)/1000人年,2020—2021年FS发病密度显著下降;冬季FS发病密度较高。结论:2015—2019年宁波市6岁以下儿童FS的发病密度整体呈升高趋势,新型冠状病毒感染期间应更加注重高风险人群和高发地区FS的健康宣教与识别处置,减少其带来的疾病负担。
Objective:To describe the epidemiological characteristics and changes of febrile seizure(FS)among children under 6 years old in Ningbo City,Zhejiang Province from 2015 to 2021.Methods:Based on the Ningbo Regional Health Information Platform,a dynamic cohort was established using vaccination registration information,and the cases of FS were identified by the diagnostic results of Chinese terms or International Classification of Diseases 10th revision(ICD-10)R56.0 code in the electronic medical records.The first visit of FS during the observation period was defined as a new case,and a recurrence case was defined as the case with a visit interval of more than 7 days.The 95%confidence interval(CI)of FS incidence density was calculated by the Poisson distribution.Results:From January 2015 to June 2020,there were 1.3 million children under 6 years old in Ningbo,with male accounting for 52.87%.The median follow-up time was 2.83(1.55-4.00)years.During the follow-up period,12776 new onset cases had FS,with more males than females,with an overall incidence density of 4.34(95%CI:4.27-4.40)/1000 person-years and a recurrence rate of 21.63%.There was a higher incidence density in children who were male,born in Ningbo and of non-mobility.The incidence density of FS was higher in urban areas than in rural and rural-urban fringe areas,and the incidence density was different among districts and counties.The peak density was found in children aged 18-23 months[8.42(95%CI:8.11-8.74)/1000 person-years].From 2015 to 2019,the incidence density increased with calendar year(P_(trend)<0.001),and the highest was 5.62(95%CI:5.43-5.81)/1000 person-years.The incidence density of FS decreased significantly during the period between 2020 and 2021.The incidence density was higher in winter.Conclusion:From 2015 to 2019,the overall incidence density of FS in children under 6 years old in Ningbo City presented an increasing trend.More attention should be paid to the health education,the improvement of the health maintenance model,the enhancement of the cognition of FS,the identification and treatment of FS among high-risk population and regions so as to prevent its recurrence and reduce the disease burden during the corona virus disease 2019(COVID-19)epide-mic.
作者
刘光旭
张良
赵厚宇
邓思危
杨君婷
李宁
马瑞
何艳
许国章
刘志科
詹思延
LIU Guangxu;ZHANG Liang;ZHAO Houyu;DENG Siwei;YANG Junting;LI Ning;MA Rui;HE Yan;XU Guozhang;LIU Zhike;ZHAN Siyan(Department of Epidemiology and Biostatistics,Peking University School of Public Health,Beijing 100191,China;Ningbo Municipal Center for Disease Control and Prevention,Ningbo 315010,Zhejiang,China;Ningbo Women&Children’s Hospital,Ningbo 315012,Zhejiang,China)
出处
《北京大学学报(医学版)》
北大核心
2025年第3期584-591,共8页
Journal of Peking University:Health Sciences
基金
国家自然科学基金(91846303)
中国中医药循证医学中心研究室主任专项(2020YJSZX-2)。
关键词
热性惊厥
发病密度
流行特征
动态队列
儿童
Febrile seizures
Incidence density
Epidemiological characteristics
Dynamic cohort
Children
