朱小宁曾建勇刘家俊吴晓鹭刘小斌

255例麻疹住院患者流行病学及临床特征

朱小宁1曾建勇2刘家俊2吴晓鹭2刘小斌2

目的 通过分析本市近6年麻疹住院患者的发病情况及临床特征，为本地区制定消除麻疹的策略及提高该疾病的诊治水平提供依据。方法 回顾性收集本市近6年麻疹住院患者的临床资料及疾控中心的麻疹IgM 抗体检测结果，用EXCLE表进行统计分析。结果 2013年我市麻疹住院患者为197例，远超其它年份，呈高发趋势，发病率达到了5.28/10 万；患者年龄分布呈现双锋型的特征；临床主要特征为发热，皮疹，咳嗽，腹泻，畏光、流泪，Koplik斑，肝功异常；大部分患者预后良好，少数发展为重症甚至死亡。结论 要想达到在本地区消除麻疹的目标，在严格执行国家卫计委现有的方案的同时，应当制定更为有效的策略；麻疹爆发期间应加强婴幼儿被动免疫，临床应当早期诊断及合理治疗。

麻疹；麻疹抗体；强化免疫活动；婴幼儿；重型麻疹

doi：10.3969/j.issn.1674-9316.2016.13.013

【Abstract】

Objective By analyzing the incidence and clinical characteristics of inpatients with measles in our hospital in the past 6 years，the strategy of eliminating measles and improving the level of treatment of the disease were provided. Methods Retrospectively collected the clinical data of inpatients with measles in our hospital and the measles IgM antibody test results from the CDC. The data were analyzed by EXCLE. Results 197 measles cases were reported with the average annual incidence of 5.28/10 million in 2013. It was far more than the other years. The age distribution of patients showing the characteristics of double front type. The main clinical features was fever，rash，cough，diarrhea，photophobia，tears，Koplik spots，abnormal liver function. Most patients have a good prognosis，but a small number of patients developed severe measles and even death. Conclusion In order to achieve the goal of elimination of measles in this area，we must carry out the Planning Commission of the existing schemes and develop a more effective strategy at the same time.

【Key words】Measles，Measles antibody，Supplenentary immunization activities，Infant，Severe measles

在全球疫苗可预防的传染病中，麻疹仍然是儿童死亡人数最多的疾病，虽然WHO 在2010年就宣布美洲地区已消除了麻疹［1］，但最近的报道显示此病在该地区有卷土重来之势［2］。2005 年中国所在的WHO 西太平洋区也承诺了于 2012 年消除麻疹，且随后卫生部制定了《2010-2012年全国消除麻疹行动方案》，但仍未能如期实现目标。从近几年全国各地关于麻疹爆发的报道显示［3-4］，我国距离消除麻疹的目标（发病率＜1 /100万）还有较大差距。我们省及我市也同样面临着诸多的挑战。……