目的 分析2024年2月至2026年2月郑州人民医院收治的急性下呼吸道感染(ALRTI)患儿的病原体分布情况及其流行病学特征。方法 选取2024年2月—2026年2月于郑州人民医院就诊的193例ALRTI患儿为研究对象,采集患儿咽拭子样本,统计患儿病原体检测结果,比较不同性别、不同年龄段、不同发病季节患儿病原体分布情况。结果 193例患儿中,经病原体检测出阳性患儿165例,总阳性检出率85.49%,检出率最高的前三位为RSV(20.73%)、MP(19.69%)、HRV(15.54%);婴儿期患儿RSV感染占比(44.83%)最高,其次为HRV感染(20.69%),幼儿期患儿RSV、HRV、MP感染占比(17.31%、17.31%、19.23%)均较高,学龄前、学龄期患儿MP感染占比(33.33%、26.32%)最高,婴儿期患儿混合感染占比(6.90%)较低,学龄前患儿混合感染占比(20.00%)较高;春季时,各病原体分布较均衡,HRV、MP、SP感染占比(14.58%、12.50%、14.58%)均较高,夏季、秋季时,MP感染率(31.82%、28.85%)较高,冬季时,RSV感染率(55.10%)较高,四个季节中混合感染患儿占比较接近,其中秋季感染率(17.31%)相对较高。结论 2024年至2026年郑州人民医院收治的急性下呼吸道感染患儿病原体中,RSV、MP为主要病原体,各呼吸道病原体随患儿年龄段、季节变化存在不同发病高峰,临床应结合实际情况早期鉴别病原体,以指导临床制定针对性治疗方案,改善患儿预后。
Objective To analyze the distribution of pathogens and the epidemiological characteristics of children with acute lower respiratory tract infections (ALRTI) admitted to Zhengzhou People’s Hospital from February 2024 to February 2026. Methods: A total of 193 pediatric patients with ALRTI who visited Zhengzhou People’s Hospital between February 2024 and February 2026 were selected as study subjects. Throat swab samples were collected from the patients, and pathogen testing results were compiled to compare the distribution of pathogens across different genders, age groups, and seasons of onset. Results: Among the 193 children, 165 tested positive for pathogens, resulting in an overall positive detection rate of 85.49%. The top three most frequently detected pathogens were RSV (20.73%), MP (19.69%), and HRV (15.54%); RSV infection had the highest prevalence (44.83%) among infants, followed by HRV infection (20.69%). Among preschoolers, the prevalence of RSV, HRV, and MP infections (17.31%, 17.31%, and 19.23%, respectively) was relatively high. MP infections were most common among preschool and school-age children (33.33% and 26.32%, respectively); the proportion of mixed infections was lower among infants (6.90%) but higher among preschoolers (20.00%); In spring, the distribution of pathogens was relatively balanced, with high proportions of HRV, MP, and SP infections (14.58%, 12.50%, and 14.58%, respectively). In summer and fall, the MP infection rate was high (31.82% and 28.85%, respectively). In winter, the RSV infection rate (55.10%) was high. The proportion of children with mixed infections was relatively similar across the four seasons, with a relatively higher infection rate (17.31%) in autumn. Conclusion: Among the pathogens identified in children with acute lower respiratory tract infections admitted to Zhengzhou People’s Hospital from 2024 to 2026, RSV and MP were the primary pathogens. The incidence peaks of various respiratory pathogens varied according to the children’s age groups and seasons. Clinicians should conduct early pathogen identification based on actual conditions to guide the development of targeted treatment plans and improve patient outcomes.
摘要:目的 分析2022—2024年深圳市福田区危重症孕产妇不同亚组(不同并发症/合并症)的流行病学特征、病因构成及相关因素,为优化区域孕产妇健康管理提供依据。方法 基于福田区危重症孕产妇监测网络,对2022年1月1日至2024年12月31日期间107921例孕产妇个案资料进行回顾性描述性分析,采用描述性流行病学方法及卡方检验分析不同因素与危重症主要并发症的关联。结果 深圳市福田区3年间危重症孕产妇共729例,总体发生率为6.75‰。各年度发生率分别为2022年6.67‰、2023年7.38‰和2024年6.33‰。危重症孕产妇中,≥35岁者占33.7%,本科及以上学历者占53.8%。初检妊娠风险评级为黄色者占比最高(41.98%),高危者占21.9%。最常见并发症为产后出血(43.89%),其次为宫缩乏力(17.28%)、前置胎盘(16.59%)、子痫/子痫前期(14.67%)和胎盘植入(13.99%)。血液系统疾病为最常见合并症(57.75%),内分泌系统疾病次之(24.42%)。单因素分析显示,产后出血的发生与高龄、产检次数不足5次、经产妇身份存在统计学关联(均P<0.05);前置胎盘的发生与高龄、低学历、非汉族、初检高危评级、产检不足5次、经产存在统计学关联(均P<0.05)。结论 深圳市福田区危重症孕产妇发生率约为6.75‰,产后出血和前置胎盘为主要并发症。单因素分析显示,高龄、产检不足、初检高危分级及经产与上述主要并发症的发生相关。应加强动态妊娠风险管理和多学科协作,完善产科早期预警体系,以降低危重症孕产妇发生率,提高母婴安全水平。
Abstract: Objective To analyze the epidemiological characteristics, etiology composition, and related factors of critically ill pregnant women in Futian District, Shenzhen, from 2022 to 2024. Methods Based on the surveillance network, a retrospective descriptive analysis was conducted on 107,921 pregnant women. Chi-square tests were used to analyze the association between different factors and major complications. Results A total of 729 critically ill pregnant women were identified (overall incidence 6.75‰).??The most common complication was postpartum hemorrhage (43.89%), followed by uterine atony (17.28%), placenta previa (16.59%), eclampsia/preeclampsia (14.67%), and placenta accreta (13.99%). Univariate analysis showed that postpartum hemorrhage was statistically associated with advanced age, <5 antenatal visits, and multiparity (all P<0.05). Placenta previa was statistically associated with advanced age, low education level, non-Han ethnicity, high-risk initial assessment, <5 antenatal visits, and multiparity (all P<0.05). Conclusion The incidence of critically ill pregnant women in Futian District is approximately 6.75‰. Univariate analysis suggested that advanced age, insufficient antenatal visits, high-risk classification, and multiparity were associated with the main complications. Dynamic risk management and multidisciplinary collaboration should be strengthened.
论著
目的 分析流行性感冒(流感)患儿的流行病学特征及病原学分布。方法 纳入2020年3月—2023年2月在开封市祥符区第一人民医院确诊为流感的394例1~10岁患儿的咽拭子标本,通过实时荧光定量聚合酶链式反应完成流感病毒检测,分析此394例流感患儿感染的病毒类型及年龄、季节、性别、年份等分布情况。结果 甲型H1N1流感病毒为本次研究检出占比最高的流感病毒,占36.04%;男女患儿之间的甲型H3、甲型H1N1、乙型BV、乙型BY流感病毒占比比较差异无统计学意义(P>0.05);春季及冬季流感患儿占比最多,分别为41.12%、35.53%,且不同季节之间的甲型H3、甲型H1N1、乙型BV、乙型BY流感病毒占比比较差异有统计学意义(P<0.05);7~10岁流感患儿占比最高,为42.13%,不同年龄段患儿之间的甲型H3、甲型H1N1、乙型BV、乙型BY流感病毒占比比较差异无统计学意义(P>0.05);2020年流感患儿占比最高,为43.40%,后续依次为2022年的29.70%,2021年的26.90%;不同年份的冬季流感患儿占比比较差异有统计学意义(P<0.05);不同年份的各年龄段流感患儿占比比较差异无统计学意义(P>0.05);各年甲型H3、甲型H1N1、乙型BV、乙型BY流感病毒占比比较差异无统计学意义(P>0.05)。结论 年龄7~10岁的患儿为流感高危群体,且甲型流感为患儿主要感染类型,而甲型流感病毒多见于春、冬季,新型冠状病毒肺炎疫情期间防控政策变化对流感流行有影响,应加强春、冬季7~10岁年龄段患儿的甲流预防工作。
Objective To analyze the epidemiological characteristics and etiological distribution of children with influenza(flu).Methods The throat swab specimens of 394 children aged 1 to 10 years old who were diagnosed with influenza at the First People's Hospital of Xiangfu District,Kaifeng City from March 2020 to February 2023 were included.The samples were analyzed by real-time fluorescence quantitative polymerase chain reaction to complete influenza virus detection and analyze the virus types and distribution of age,season,gender,year,etc.among these 394 children with influenza were analyzed.Results Influenza A H1N1 virus was the influenza virus with the highest proportion detected in this study,accounting for 36.04%;there were differences in the proportions of influenza A H3,A H1N1,BV,and B BY influenza viruses between male and female children,with no statistical significance(P>0.05);the proportion of children with influenza is the largest in spring and winter,41.12% and 35.53% respectively,and proportions of influenza A H3,A H1N1,B BV,and B BY influenza in different seasons were significantly different(P<0.05).Children aged 7 to 10 accounted for the highest proportion of influenza patients,42.13%.Among children of different ages,the proportion of influenza A H3,A H1N1,B BV,B BY had no statistically significant difference(P>0.05).The proportion of children with influenza in 2020 was the highest at 43.40%,followed by 29.70% in 2022 and 26.90% in 21;in different years there is a statistically significant difference in the proportion of children with influenza in winter(P<0.05).There is no statistically significant difference in the proportion of children with influenza of all ages in different years(P>0.05).The preportions of influenza A H3 and A H1N1,B BV and B BY viruses in each year,had no statistically significant difference(P>0.05).Conclusions Children aged 7 to 10 years old are a high-risk group for influenza,and influenza A is the main type of infection in children.Influenza A viruses are more common in spring and winter.Changes in prevention and control policies during the new coronavirus pneumonia epidemic have an impact on the epidemic of influenza.Therefore,prevention of influenza A for children aged 7 to 10 years old in spring and winter should be strengthened.
临床诊疗
目的 探讨市区院前急救流行病学特征,为制定院前急救策略和合理调配急救资源提供参考依据。方法 采用回顾性资料收集方法选取我院2013—2014年院前急救患者14000例(对照组),2017年院前急救患者9 630例(观察组)作为研究对象,对两组的性别、年龄、死亡原因等建立数据库,采用描述性研究和圆形分布方法进行统计分析,并对比两组数据,分析院前急救患者变化趋势。结果 对照组急救患者性别男性所占比例高于女性,年龄45~55岁所占比例最高,死亡原因创伤所占比例最高,心脑血管疾病其次;观察组急救患者性别男性所占比例高于女性,但低于对照组男性所占比例,年龄45~55岁所占比例最高,但比例低于对照组,死亡原因创伤所占比例最高,心脑血管疾病其次。结论 根据院前急救时间分布规律合理调配急救资源,充分发挥院前急救功能,提高院前急救水平。
论著
目的 总结本地区低龄婴儿侵袭性B族链球菌(GBS)感染的流行病学特点, 为临床预防和诊治提供指导。方法 对2012年1月—2015年12月广州地区两家三甲妇儿专科医院收治的0~89 d低龄婴儿侵袭性GBS感染病例进行回顾性分析。结果 研究期间两院共收治侵袭性GBS感染病例120例,2015年感染病例数为2012年的2.8倍,感染病例的发生无明显季节倾向。早发型感染以败血症合并肺炎(46.3%)为主,围产期多伴有一个或以上的高危因素,死亡率为7.4%;晚发型感染以败血症合并脑膜炎(占42.4%),多以发热为首发症状,其中42%伴有神经系统症状,14.6%遗留神经系统后遗症。结论 广州地区低龄婴儿侵袭性GBS感染病例呈逐年增加趋势,临床应重视新生儿GBS感染的预防,加强感染高风险新生儿的管理,及时诊治,改善预后。
Objective To describe the epidemiological characteristics of invasive group B streptococcal (GBS) infection among infants during the past 4 years in Guangzhou, in order to provide scientific basis for the prevention and control of the disease. Methods Medical records of infants with invasive GBS infection from two tertiary hospitals in Guangzhou from January 2012 to December 2015 were reviewed. Results There were 120 infants with invasive GBS infections during the past 4 years in two tertiary hospitals, the number of patients increased from 2012 to 2015, and the occurrence of infectionshad no obvious seasonal tendencies. Among infants with EOD, the most common syndrome was sepsis complicated pneumonia (46.3%), respiratory sign and at least one of perinatal risk factors were commonly recorded, and the mortality rate was 7.4%. By contrast, a higher proportion of late-onset cases manifested as sepsis associated with meningitis (42.4%), fever was the most common presentation and 42% LOD cases accompanied by neurological symptoms, 14.6% infants had neurological sequelae. Conclusion The number of GBS-infected infants increased during the past 4 years in Guangzhou. Relevant departments should pay attention to the prevention of neonatal GBS infection, strengthen the management of high risk newborns to improve the prognosis.