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目的了解婴儿麻疹病例发病的临床特征,探讨其发病的危险因素,为控制小月龄婴儿麻疹发病提供依据。方法采用描述性流行病学方法,分析东莞市长安镇2004~2015年≤1岁婴儿麻疹住院病例的临床特征。采用1∶1配对病例对照研究,用Logistic回归分析法研究婴儿麻疹病例的危险因素。结果 490例婴儿麻疹住院病例中以<8月龄居多,占83.87%(411/490),主要症状为发热(100%)、皮疹(100%)、咳嗽(100%)、卡他症状(100%)、Koplik斑(75.92%),婴儿麻疹病例最常见的合并症是支气管肺炎(67.96%)。多因素回归分析显示,<8月龄婴儿麻疹病例发病的影响因素有:婴儿发病前3周内接触史(OR=8.57,95%CI:2.91~16.22)、发病前3周内就诊史(OR=7.82,95%CI:3.70~11.22)、流动人口(OR=4.96,95%CI:3.69~9.82)、母亲接种史(OR=0.008,95%CI:0.001~0.019)和母亲患过麻疹(OR=0.003,95%CI:0.002~0.007)。结论婴儿麻疹病例发病以<8月龄为主,其典型临床症状是发热、皮疹、咳嗽、卡他症状、Koplik斑。发病前3周内接触史、发病前3周内就诊史和流动人口是婴儿麻疹发病的危险因素,母亲麻疹疫苗接种史和母亲患过麻疹是其保护因素。
Objective To understand the clinical features of infantile measles and to explore the risk factors for the onset of measles in infants. Methods Descriptive epidemiological methods were used to analyze the clinical characteristics of hospitalized cases of infants with measles less than 1 year from 2004 to 2015 in Chang’an Town, Dongguan City. A 1: 1 matched case-control study was used to study the risk factors for infant measles cases using Logistic regression analysis. Results The majority of 490 infants with measles were hospitalized at <8 months, accounting for 83.87% (411/490). The main symptoms were fever (100%), skin rashes (100%), cough (100%) and catarrhal symptoms %), Koplik spot (75.92%), and the most common comorbidity of infant measles is bronchopneumonia (67.96%). Multivariate regression analysis showed that the incidence of measles cases in infants <8 months of age was related to contact history within 3 weeks before onset (OR = 8.57, 95% CI: 2.91 to 16.22), history of visits within 3 weeks before onset = 7.82, 95% CI: 3.70-11.22), floating population (OR = 4.96,95% CI: 3.69-9.282), mother’s history of vaccination (OR = 0.008,95% CI: OR = 0.003, 95% CI: 0.002-0.007). Conclusion The incidence of measles in infants was mainly at <8 months. The typical clinical symptoms were fever, rash, cough, catarrhal symptoms and Koplik plaque. History of exposure within 3 weeks prior to onset, history of visit within 3 weeks prior to onset, and floating population are risk factors for the onset of measles in mothers. The history of measles vaccination and mother’s measles immunization are the protective factors.