摘要
目的 了解天津市不同水痘疫苗接种史对儿童水痘病例临床特征及诊疗费用的影响。方法 采用分层整群随机抽样方法选取天津市2018—2019年1 212名水痘患儿作为研究对象,通过中国疾病控制信息系统和天津市免疫规划信息系统获得患儿水痘发病数据和水痘疫苗接种史资料,经调查随访和查阅病历获得水痘病例的临床特征和费用信息。对不同水痘疫苗接种史的患儿进行临床特征及诊疗费用的比较。结果 无水痘疫苗接种史、1剂次、2剂次水痘疫苗接种史的患儿中重度出疹比例(分别为51.6%、43.2%和5.2%)差异有统计学意义(χ^(2)=43.517,P<0.05),出疹持续时间[分别为(6.12±3.49)d、(5.47±2.92)d和(5.11±2.08)d]差异有统计学意义(F=7.401,P<0.05),有疫苗接种史水痘患儿中重度出疹比例与出疹持续时间少于无水痘疫苗接种史患儿。无水痘疫苗接种史、1剂次、2剂次水痘疫苗接种史水痘患儿的住院比例(分别为7.5%、2.9%和1.6%,χ^(2)=14.305,P<0.05)和诊疗花费(中位数分别为284、218、200元,H=13.022,P<0.05)差异有统计学意义,接种疫苗可以降低患儿的住院比例同时降低患儿的诊疗花费。随着接种剂次增加,出疹的范围随之减少(r=4.064,P<0.05),发热症状的比例(分别为71.0%、59.2%和39.7%)也随之降低(χ^(2)=35.019,P<0.05)。结论 接种疫苗可以减轻水痘的部分临床症状及减少诊疗花费,随着免疫接种剂次的增加,水痘病例发热比例和出疹范围有所减少。儿童水痘的临床诊断要考虑疫苗接种史。
Objective To study the effect of different varicella vaccination histories on the clinical characteristics and treatment costs of varicella in children in Tianjin city of China.Methods A total of 1 212 children with varicella in Tianjin from 2018 to 2019 were selected by stratified cluster random sampling.The data of varicella incidence and varicella vaccination history were obtained from China Disease Control Information System and Tianjin Immunization Planning Information System.The clinical and cost information of varicella cases were obtained through follow-up investigation and medical record review.The clinical characteristics and treatment costs of children with different vaccination histories were compared.Results There were significant differences in the proportion of moderate to severe rash among children without or with 1 or 2 dose vaccination history(51.6%,43.2%,5.2%,respectively,χ^(2)=43.517,P<0.05),and the duration of eruption was statistically different [(6.12±3.49) d,(5.47±2.92) d,(5.11±2.08) d,respectively,F=7.401,P<0.05].The proportion and duration of moderate to severe rash with vaccination history were less than those without vaccination history.The proportion of hospitalized children with different vaccination histories(7.5%,2.9%,1.6%,respectively,χ^(2)=14.305,P<0.05)and the cost of diagnosis and treatment were statistically different(284,218and 200yuan,respectively,H =13.022,P<0.05).Vaccination could reduce the proportion of hospitalized children and reduce the cost of diagnosis and treatment.With the increase of inoculation times,the range of rash decreased(r=4.064,P <0.05),and the proportion of fever symptoms also decreased(71.0%,59.2% and 39.7%,respectively,χ^(2)=35.019,P<0.05). Conclusions Vaccination can reduce some clinical symptoms of varicella and reduce the cost of diagnosis and treatment.With the increase of vaccination times,the fever rate and rash range of chickenpox cases are reduced.The clinical diagnosis of varicella should be combined with vaccination history.
作者
董晓春
李琳
DONG Xiao-chun;LI Lin(Department of Infectious Diseases,Tianjing Municipal Center for Disease Control and Prevention,Tianjin 300011,China)
出处
《中国病毒病杂志》
CAS
2022年第3期180-184,共5页
Chinese Journal of Viral Diseases
基金
国家“十三五”艾滋病和病毒性肝炎等重大传染病防治科技重大专项(2017ZX10103007-002)。
关键词
水痘疫苗
接种
剂次
临床特征
诊疗费用
Varicella vaccine
Inoculation
Doses
Clinical features
Diagnosis and treatment expenses
