方艳, 宋铁, 代吉亚, 傅军华, 易建荣. 某综合医院呼吸道症候群用于呼吸道疾病监测可行性评价[J]. 疾病监测, 2009, 24(7): 487-491. DOI: 10.3784/j.issn.1003-9961.2009.07.006
引用本文: 方艳, 宋铁, 代吉亚, 傅军华, 易建荣. 某综合医院呼吸道症候群用于呼吸道疾病监测可行性评价[J]. 疾病监测, 2009, 24(7): 487-491. DOI: 10.3784/j.issn.1003-9961.2009.07.006
FANG Yan, SONG Tie, DAI Ji-ya, FU Jun- hua, YI Jian-rong. Feasibility of respiratory syndrome for respiratory diseases surveillance in a hospital[J]. Disease Surveillance, 2009, 24(7): 487-491. DOI: 10.3784/j.issn.1003-9961.2009.07.006
Citation: FANG Yan, SONG Tie, DAI Ji-ya, FU Jun- hua, YI Jian-rong. Feasibility of respiratory syndrome for respiratory diseases surveillance in a hospital[J]. Disease Surveillance, 2009, 24(7): 487-491. DOI: 10.3784/j.issn.1003-9961.2009.07.006

某综合医院呼吸道症候群用于呼吸道疾病监测可行性评价

Feasibility of respiratory syndrome for respiratory diseases surveillance in a hospital

  • 摘要: 目的探讨呼吸道症候群监测应用于已知呼吸道疾病监测的可行性。 方法对广州市一综合医院信息管理系统(HIS)2005年全年门诊、住院部和X线检查室的临床记录开展回顾性调查,筛选呼吸道症候群监测指标,并与同期广州市流感样病例和该院法定报告呼吸道传染病的发病数进行相关分析。结果从门诊、住院部和X线检查室的临床记录中共筛选出门诊的肺炎类似诊断等7个症候群、住院部的肺炎类似诊断等4个症候群和X线检查室的门诊X线检查人次/阳性人次等4个症候群拟作为症候群监测指标。其中,门诊肺炎类似诊断与提前4周的流感样病例相关关系最佳(Ir/I=0.558),经相关系数假设检验,门诊肺炎类似诊断和本周流感样病例的相关系数只与提前4周的流感样病例相关系数差异有统计学意义(Iu/I=2.09,IP/I0.05),提示门诊肺炎类似诊断的就诊高峰略早于流感样病例,具有较好的指示流感流行的特异性与及时性。住院部肺炎、哮喘类似诊断、门诊X线检查人次/阳性人次等症候群监测指标与不同时间移位的流感样病例有相关性,提示其指示流感流行的特异性较好,但这些指标和本周流感样病例的相关系数与其他不同时间移位的相关系数差异无统计学意义(IP/I0.05),提示其指示流感流行的及时性不好。结论门诊肺炎类似诊断作为症候群监测指标应用于已知呼吸道疾病监测(如流感样病例监测)具有一定可行性,住院部哮喘、肺炎和门诊X线检查人次/阳性人次等指标的应用意义次之。

     

    Abstract: ObjectiveTo evaluate the feasibility to use respiratory syndrome indicators in respiratory disease surveillance. MethodsThe respiratory syndrome indicators were selected by analyzing the clinical records (in 2005) of outpatient department, inpatient department and X ray detection room in a hospital included in the hospital information system (HIS) in Guangzhou, and the correlation with the case number of influenza like illness (ILI) in Guangzhou and the case number of notifiable respiratory diseases in the hospital in same period was analyzed. ResultsSeven syndromes including pneumonia like illness in outpatient department, 4 syndromes including pneumonia like illness in inpatient department and 4 syndromes in X-ray room including x-ray test rate/positive rate in outpatient department were selected as candidate syndrome indicators. Curves of pneumonia like illness in outpatients closely correlated with ILI curve when it moved 4 weeks backward with the correlation coefficients of 0.558 (Iu/I=2.09,IP/I0.05), but without significant correlation with other times ILI cases. It indicated that the peak of pneumonia like illness was earlier than ILI in outpatient department, which suggested that the diagnosis of pneumonia like illness in outpatient department could indicate influenza epidemic specifically and timely. Curve of pneumonia like illness and asthma like illness in inpatient department, X-ray test rate/positive rate in outpatient department correlated with the curve of ILI in different time periods, which showed that these indicators could predict influenza specifically, but the difference on the correlation coefficients of these indicators with ILI in different period had no statistical significance (IP/I0.05), which indicated that they could not predict influenza epidemic timely. ConclusionIt is feasible to use pneumonia like illness in outpatient department as syndrome indicator for the surveillance of respiratory diseases (e.g. influenza like illness), indicators of pneumonia like illness and asthma like illness in inpatient department, x-ray test, rate/positive rate in outpatient department are less effective.

     

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