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目的了解婴儿麻疹病例分布特征和发病危险因素,为探讨针对性的预防控制措施提供参考。方法分析浙江省2009~2012年婴儿麻疹病例的分布特征,用χ2检验比较分布差异;以监测系统报告的麻疹确诊病例为病例组,非麻疹病例为对照组,开展频数匹配的病例对照研究,用Logistic回归分析危险因素。结果浙江省2009~2012年婴儿麻疹病例占总病例数的38.80%,6~8月龄病例占婴儿麻疹的58.48%。麻疹病例的男女性别比为1.95∶1.00,医院暴露比例为46.20%,有咳嗽、口腔黏膜斑和卡他症状的比例分别为88.28%、39.72%和78.82%。多因素分析显示,8~11月龄麻疹病例中含麻疹成分疫苗(Measles-containing Vaccine,MCV)免疫史有统计学意义,比值比(Odds Ratio,OR)=0.49,95%可信区间(Confindence Interval,CI):0.27~0.89;0~7月龄发病危险因素则是在发病地居住时间<3个月、出疹性病例接触史有统计学意义,OR分别为2.07(95%CI:1.21~3.52)、4.87(95%CI:1.62~14.62)。结论婴儿麻疹病例症状相对较重,流动人口、接触史和医院暴露等是危险因素,接种MCV是8~11月龄婴儿的有效保护措施。建议提高8月龄MCV及时接种率,加强流动儿童管理,减少医疗机构的暴露及出疹性病例的接触机会。
Objective To understand the distribution characteristics and risk factors of measles cases in infants and provide references for the targeted prevention and control measures. Methods The distribution characteristics of measles cases in infants aged from 2009 to 2012 in Zhejiang Province were analyzed. Chi-square test was used to compare the distribution differences. The measles cases reported by monitoring system were selected as case group, non-measles cases as control group, frequency-matched case-control study Logistic regression analysis of risk factors. Results The measles cases in Zhejiang Province from 2009 to 2012 accounted for 38.8% of the total number of cases. The cases of 6-8 months old accounted for 58.48% of the measles cases. The ratio of male to female in measles cases was 1.95:1.00, and the ratio of hospital exposure was 46.20%. There were 88.28%, 39.72% and 78.82% of cough, oral mucosa spots and catarrhal symptoms respectively. Multivariate analysis showed that measles-containing vaccine (Measles-containing Vaccine, MCV) immunization history was statistically significant in 8 ~ 11 months old measles cases, odds ratio (OR) = 0.49, 95% confidence interval Interval, CI): 0. 27 ~ 0. 89; 0 ~ 7 months of age risk factors are living in the place of residence <3 months, history of exposure to rash cases were statistically significant, OR were 2.07 (95% CI: 1.21 ~ 3.52), 4.87 (95% CI: 1.62 ~ 14.62). Conclusion The symptoms of infantile measles are relatively heavy, and floating population, exposure history and hospital exposure are risk factors. Inoculation of MCV is an effective protective measure for infants aged 8-11 months. It is proposed to increase the timely vaccination rate for MCVs of 8 months of age, to strengthen the management of migrant children and to reduce the exposure of medical institutions to exposure to rash cases.