【作者】 汤奋扬； 霍翔； 李亮； 祖荣强； 许可； 祁贤； 吴斌； 嵇红； 朱凤才；

【Author】 TANG Fen-yang,HUO Xiang,LI Liang,ZU Rong- qiang,XU Ke,QI Xian,WU Bin,JI Hong,ZHU Feng-cai.Jiang Su Center for Disease Control and Prevention, Nanjing 210009,China

【机构】 江苏省疾病预防控制中心；

【摘要】 目的分析甲型H1N1流感患者发生重症临床表现的危险因素,为科学防控提供依据。方法调查江苏省2009年6～12月间甲型H1N1流感确诊病例,利用统一设计的调查表收集信息,应用SAS 9.1.3软件进行单因素和多因素非条件Logistic回归分析重症危险因素和风险比值比(OR值)。结果单因素Logistic回归分析显示,年龄、发病与首次就诊时间间隔、体重指数(BMI)、妊娠和慢性基础性疾病史为导致重症的影响因素(P<0.01)。多因素Logistic回归分析显示,年龄、发病与首次就诊时间间隔、BMI和慢性基础性疾病史进入了最终模型(P<0.05),其中慢性基础性疾病史对模型贡献最大(标准化回归系数β=0.72),其他依次为年龄(β=0.43)、BMI(β=0.35)和发病与首次就诊时间间隔(β=0.25)。因素合并分析显示,发病风险随着危险因素数量的增加而增加,存在剂量效应关系(P<0.01)。结论有慢性基础性疾病史、5岁以下儿童和年龄较大者、超重或肥胖者为甲型H1N1流感重症高危人群,感染甲型H1N1流感应尽量早期就诊,减少重症情况的发生。更多还原

【Abstract】 Objective To evaluate the risk factors for severe cases of influenza A H1N1.Methods The confirmed cases of influenza A H1N1 during June to December 2009 in Jiangsu province were investigated using unified designed questionnaires.Univariate and multivariate non-conditional Logistic regression were employed to analyze the risk factors and odds ratio(OR) with SAS 9.1.3.Results Age,interval between incidence and first-visit,BMI,pregnant and chronic comorbid illness were identified as the risk factors of severe cases in univariate Logistic regression models.And age,interval between incidence and first-visit,BMI and chronic comorbid illness got into the final multivariate Logistic model.Among which,the contribution of chronic comorbid illness to the model was the greatest(β=0.72),followed with age(β=0.43),BMI(β=0.35) and interval between incidence and first-visit(β=0.25).Joint effect analysis indicated a dose-response relationship between the increased risk and the amount of risk factors.Conclusions Individuals with risk factors for severe cases should receive early-treatment.更多还原