【作者】 陈磊； 曾艺； 陈先刚； 汪强；

【Author】 CHEN Lei;ZENG Yi;CHEN Xian-gang;WANG Qiang;Yu zhong district Center for disease control and prevention,Chongqing;

【机构】 重庆市渝中区疾病预防控制中心传染病防控科；

【摘要】 目的通过对2010—2016年重庆市渝中区报告儿童重型流行性乙型脑炎(简称乙脑影响因素的分析,为该地区儿童重型乙脑的防控提供科学依据。方法采用描述性流行病学方法对重庆市渝中区2010—2016年报告的儿童乙脑患者的基本特征、分型及其差异性、乙脑病情影响因素进行分析。采用SPSS20.0软件对乙脑发病特征差异性进行统计学分析,用多因素逐步logistic回归分析儿童重型乙型脑炎的影响因素。结果 2010—2016年,重庆市渝中区共报告儿童乙脑病例725例,主要为幼托儿童,其中重型344例(47.45%)。人群分布、诊断型别、是否住院、发病前25 d是否有外出史、头痛、精神萎靡、烦躁、意识障碍、抽搐、脑膜刺激征、病理反射肌张力增强等18个因素在非重型组与重型组间差异均有统计学意义(P<0.05);出现惊厥(P<0.000 1,OR:2.876～8.237)、意识障碍(P=0.013,OR:1.109～2.436)、脑膜刺激征(P=0.000 5,OR:1.350～2.963)、病理反射肌张力增强(P=0.0004,OR:1.377～3.023)的乙脑患儿更易发展为重型乙脑。结论儿童重型乙脑病情重、发展较快,因此临床医生在接诊儿童乙脑患者时应注意观察患者惊厥、意识障碍等症状,避免轻型乙脑患者发展为重型。更多还原

【Abstract】 Objective Conduct a influence factors analysis of heavy children’s epidemic encephalitis type B of Yuzhong district in Chongqing in 2010-2016 to provide the scientific basis for prevention and control.Methods The basic characteristics,classification and its diversity of the heavy children’s epidemic encephalitis type B were analyzed by the method of descriptive epidemiology.SPSS 22.0 software was used for the significant difference analysis between basic characteristics,and the influencing factors with the method of multiple stepwise logistic regression.Results A total of 725 cases of children’s epidemic encephalitis type B were reported in Yuzhong district of Chongqing from 2010-2016,mainly for childcare children,with 344 cases(47.45%)of the heavy.There were significant differences in different occupation,diagnostic categories,whether in the hospital,25 days before the onset of whether to go out,headaches,depression,irritability,disturbance of consciousness and convulsions,meningeal irritation,pathological reflex muscle tension enhanced(P<0.05) between the illness groups;The children’s epidemic encephalitis type B with the convulsions(P<0.0001,OR:2.876～8.237),disturbance of consciousness(P = 0.013,OR:1.109 ～ 2.436),meningeal stimulation(P = 0.0005,OR:1.350 ～ 2.963) and pathological reflex muscle tension enhanced(P = 0.0004,OR:1.377 ～ 3.023)were more likely to develop to the heavy.Conclusion The children’s heavy epidemic encephalitis type B were more serious and the development faster,the clinicians should observe symptoms more careful such as consciousness and convulsions,avoiding the light patients turn to the heavy one.更多还原