济南市1 300例儿童呼吸道疾病流行病学分析

目的 分析济南市儿童呼吸道疾病流行病学特征,为卫生行政部门制定相关控制措施提供科学依据。方法 以济南市齐鲁医院2013年1月至2014年5月1 300例呼吸道疾病患儿为研究对象,整理临床资料,对呼吸道疾病种类、分布以及病原菌进行数据统计分析。结果 1 300例呼吸道疾病患儿中肺炎373例(28.7%)、肺结核3例(0.2%)、急性支气管炎467例(35.9%)、哮喘102例(7.8%)和上呼吸道感染355例(27.3%);上呼吸道感染包括扁桃体炎(168例,12.9%)、咽炎(91例,7.0%)、喉炎(52例,4.0%)和咽喉炎(44例,3.4%)。患儿年龄分布为<1岁组71例(5.5%)、1~岁组385例(29.6%)、3~岁组534例(41.1%)、7~岁组258例(19.8%)和>13岁组52例(4.0%);发病有明显的季节分布,春季为364例(28.0%)、夏季为163例(12.5%)、秋季为315例(24.2%)和冬季为458例(35.2%);患儿地区分布明显,其中城区516例(39.7%)、城郊225例(17.3%)、乡镇376例(28.9%)和农村183例(14.1%)。共分离鉴定725株病原菌,其中以肺炎支原体最多(349株,48.1%),其次为流感嗜血杆菌(136株,18.8%)、肺炎链球菌(103株,14.2%)、肺炎克雷伯菌(82株,11.3%)、鲍曼不动杆菌(38株,5.2%)、阴沟肠杆菌(35株,4.8%)、化脓链球菌(22株,3.0%)、产碱菌属(17株,2.3%)、白色假丝酵母菌(16株,2.2%)和产吲哚黄杆菌(9株,1.2%)。临床治愈1 288例,治愈率为99.1%。结论 济南市儿童呼吸道疾病以急性支气管炎、肺炎和上呼吸道感染常见,发病多集中在3~6岁学龄前儿童,多发于春冬两季,且多见于城镇儿童。

Epidemiological investigation on respiratory diseases in 1 300 children, in Jinan, Shandong

Objective To analyze the characteristics of respiratory diseases and to provide scientific basis for developing relevant control measures. Methods 1 300 children with respiratory diseases were treated in hospitals,from Jan. 2013 to May 2014,in the city of Jinan. Characteristics of respiratory diseases were analyzed. Results The distribution of respiratory diseases in children appeared as:373 cases of pneumonia (28.7%),3 cases of pulmonary tuberculosis (0.2%),467 cases of acute bronchitis (35.9%),102 cases of asthma (7.8%),and 355 cases of upper respiratory tract infection (27.3%). The upper respiratory tract infection contained 168 cases of tonsillitis (12.9%),91 cases of pharyngitis (7.0%),52 cases of laryngitis (4.0%) and 44 cases of iaryngopharyngitis (3.4%). The age distribution of cases with children respiratory diseases appeared as:71 cases <1 years old (5.5%),385 cases as 1-2 years old (29.6%),534 cases as 3-6 years old (41.1%),258 cases as 7-12 years old (19.8%) and 52 cases as >13 years old (4.0%). The seasonal distribution of children respiratory diseases appeared as:364 cases in Spring (28.0%),163 cases in summer (12.5%),315 cases in autumn (24.2%) and 458 cases in winter (35.2%). Regional distribution of children respiratory diseases appeared as:516 cases in urban area (39.7%) ,225 cases in suburb (17.3%),376 cases in townships (28.9%) and 183 in villages (14.1%). 725 strains were isolated and identified that containing 349 strains(48.1%) of Mycoplasma pneumoniae,136 strains(18.8%) of Haemophilus influenza,103 strains(14.2%) of Streptococcus pneumoniae,82 strains(11.3%)of Klebsiella pneumoniae,38 strains(5.2%) of Acinetobacter baumannii,35 strains(4.8%) of Enterobacter cloacae,22 strains (3.0%) of Streptococcus pyogenes,17 strains(2.3%) of Alcaligenes,16 strains (2.2% of Candida albicans) and 9 strains (1.2%) of Flavobacterium indologenes. 1 288 cases (99.1%) were cured. Conclusion The common respiratory diseases would include bronchiolitis,pneumonia and upper respiratory tract infections in children,mostly attacking 3-6 year-olds at preschool stage,with spring,winter,urban and township as the prevalent seasons and areas.