中国循证儿科杂志2012，Vol.7Issue(2)：128-131,4.DOI:10.3969/j.issn.1673-5501.2012.02.010
经病原学确诊的207例儿童麻疹临床特征分析
Clinical characteristics of 207 measles cases with etiological diagnosis
黄辉 1邓莉 1郑崇光 1邓洁 2陈冬梅 2钱渊2
作者信息
- 1. 首都儿科研究所附属儿童医院感染消化科,北京,100020
- 2. 首都儿科研究所病毒研究室,北京市感染与免疫中心实验室北京,100020
- 折叠
摘要
Abstract
Objectives To understand the influence of measles vaccination on clinical manifestations of measles in children, different characteristics of measles in infants and children in order to improve early diagnosis of measles by analyzing the characteristics of measles cases with laboratory confirmed etiological data. Methods Clinical data were collected from children who visited the Department of Outpatient Infectious Diseases and hospitalized with clinical diagnosis of measles and confirmed by measles specific IgM and measles virus N gene fragment from January 2002 to December 2010. Measles specific IgM antibodies were tested using serum samples with ELISA. Measles virus N gene fragment was amplified from specimens of throat swabs and fresh urine by reverse transcription-polymerase chain reaction ( RT-PCR ). Analyses were performed in vaccinated and unvaccinated cased separately. Results ① In total, 207 cases of measles in children with etiological diagnosis were analyzed, including 123 males and 84 females, 53 vaccinated and 154 unvaccinated. Age distribution ranged from 0 to 15 years, including 69 cases ( 33. 3% ) of younger than 8 months ( who had not reached the age for primary measles vaccination ), and 45 cases ( 21. 7% ) of younger than 1 year of age. ②Cases with Beijing local residency was more common in vaccinated group than that in unvaccinated group. The peak incidence was found in April for all cases in two groups. 15.4% ( 24/154 ) cases with known exposure history in measles unvaccinated group and in unvaccinated group and 16. 9% ( 9/53 ) in measles vaccinated group, with no significant difference between two groups. ③The proportions of measles with symptoms of mucosa spots ( Koplik spots ) and cough were significantly lower in vaccinated group than in unvaccinated group while the other symptoms had no significant difference betweentwo groups. ④ Of 154 unvaccinated cases, 97 were younger than 1 and 57 older than 1 year old. Symptoms of eyes was more common in the subgroup older than 1 year of age. Conclusions Measles cases with younger age have been increasing in recent years in Beijing. More and more measles cases for children have presented with atypical clinical manifestations. Most of the measles cases in this study were younger than 8 months of age which is before EPI for measles vaccination or older than 8 months of age but missed vaccination. The data indicated that strengthening measles immunization program was necessary, and early and rapid etiological diagnosis for atypical measles was important for early isolation of the cases.关键词
儿童/麻疹/临床表现/疫苗接种Key words
Children/Measles/Clinical manifestation/Vaccination引用本文复制引用
黄辉,邓莉,郑崇光,邓洁,陈冬梅,钱渊..经病原学确诊的207例儿童麻疹临床特征分析[J].中国循证儿科杂志,2012,7(2):128-131,4.
