芜湖市小儿肠套叠流行特征及与气象因素之间的相关性分析

褚振杰; 刘洁; 随帮志; 朱庆华; 夏雨; 段光琦

doi:10.16462/j.cnki.zhjbkz.2023.05.018

芜湖市小儿肠套叠流行特征及与气象因素之间的相关性分析

doi: 10.16462/j.cnki.zhjbkz.2023.05.018

241000 芜湖，皖南医学院第一附属医院小儿外科

基金项目:

安徽省自然科学基金 1808085MH271

详细信息

通讯作者:
段光琦，E-mail: duangq453@sina.com

中图分类号: R726.1
计量
- 文章访问数: 117
- HTML全文浏览量: 62
- PDF下载量: 12
- 被引次数: 0
出版历程
- 收稿日期: 2021-05-19
- 修回日期: 2021-09-14
- 刊出日期: 2023-05-10

A correlation analysis between epidemiological characteristics of pediatric intussusception and meteorological factors in Wuhu

Department of Pediatric Surgery, First Affiliated Hospital of Wannan Medical College, Wuhu 241000, China

Funds:

Natural Science Foundation of Anhui Province 1808085MH271

More Information

Corresponding author: DUAN Guangqi，E-mail: duangq453@sina.com

摘要

摘要: 目的了解芜湖市近6年来小儿肠套叠流行病学特征及其与部分气象因素的相关性，在增加对肠套叠发病认识的同时可为肠套叠预测模型的建立提供理论依据。方法回顾性收集2014年4月―2019年12月于皖南医学院第一附属医院就诊的小儿肠套叠病例，分析其相关统计学特征和部分临床特征，采用圆形分布法和系统聚类中的Q型聚类分析其季节性，用Poisson回归分析研究肠套叠的发病与纳入的6种气象因素之间的相关性。结果共收集肠套叠1 026例，其中原发性肠套叠986例，男女性别比为1.87∶1， < 2岁儿童占52.02%。主要临床表现为腹痛或哭闹(69.57%，686/986)、呕吐(62.98%，621/986)、血便(22.41%，221/986)等。结合圆形分布法(Z=7.62，P < 0.001)和聚类分析结果，肠套叠的发病有明显的高峰(5―6月)，证明其发病存在季节性。Poisson回归分析结果显示：每月肠套叠发病数与月日照总量呈正相关(β=0.004，P=0.005)，与月平均风速(β=-0.433，P=0.016)、月平均气压(β=-0.064，P < 0.001)、月平均气温(β=-0.066，P < 0.001)呈负相关，与月降水量、月平均相对湿度无明显相关(均有P>0.05)。结论在芜湖市，肠套叠的发病具有一定的季节性，并与气候因素相关，好发于日照量足、风速和平均气压较低且气温适中的月份。
- 肠套叠 /
- 流行病学 /
- 气象 /
- 儿童
Abstract: Objective This study aims to elucidate the epidemiological characteristics of pediatric intussusception over the past six years and its association with meteorological factors in Wuhu, with a view to enhancing our understanding of the condition and providing a theoretical foundation for the development of predictive models. Methods A retrospective analysis was performed on the statistical and clinical features of pediatric intussusception cases treated at the First Affiliated Hospital of Wannan Medical College between April 2014 and December 2019. Seasonal patterns were assessed using the circular distribution method and Q-type clustering in systematic clustering. The Poisson regression was used to analyze the correlations between intussusception incidence and six meteorological factors. Results A total of 1 026 intussusception cases were collected, including 986 primary intussusceptions. The male-to-female ratio was 1.87∶1, with 52.02% of patients being no more than two years old. The predominant clinical symptoms were abdominal pain or crying (69.57%, 686/986), vomiting (62.98%, 621/986), and bloody stool (22.41%, 221/986). Circular distribution analysis (Z=7.62, P < 0.001) and clustering analysis revealed distinct peaks in intussusception incidence from May to June, indicating seasonality. Poisson regression analysis demonstrated positive correlations between monthly intussusception incidence and total monthly sunshine (β=0.004, P=0.005), and negative correlations with monthly average wind speed (β=-0.433, P=0.016), monthly average air pressure (β=-0.064, P < 0.001), and monthly average air temperature (β=-0.066, P < 0.001). No significant associations were found with monthly precipitation and monthly average relative humidity (all P>0.05). Conclusions In Wuhu, intussusception exhibits seasonal occurrence patterns and is influenced by climate factors. Months characterized by abundant sunshine, low wind speed, average air pressure, and moderate temperature are associated with higher incidence rates.
- Intussusception /
- Epidemiology /
- Meteorology /
- Children

HTML全文

图 1 芜湖市2015―2019年肠套叠各月发病数聚类树状图

Figure 1. Cluster tree diagram of monthly incidence of intussusception in Wuhu from 2015 to 2019

下载: 全尺寸图片幻灯片

图 2 2014年4月―2019年12月各月肠套叠发生情况(A.逐月发生情况; B.各月累计发生情况)

Figure 2. Distribution of intussusception from Apr 2014 to Dec 2019 (A. Monthly occurrence; B. Cumulative monthly occurrence)

下载: 全尺寸图片幻灯片

图 3 2014年4月-2019年12月各气因素与肠套叠发病数的月变化

注: A为月平均气温与肠套叠发生情况; B为月日照总量与肠套叠发生情况: C为月降水量与肠發叠发生情况: D为月平均气压与肠套叠发生情况; E为月平均相对湿度与肠套叠发生情况；F为月平均风速与肠套叠发生情况。

Figure 3. Monthly variation of climatic factors and intussusception cases from Apr 2014 to Dee 2019

下载: 全尺寸图片幻灯片

表 1 原发性肠套叠患者的年龄和性别分布

Table 1. Age and sex distribution of patients with primary intussusception

变量	2014(4―12月)	2015年	2016年	2017年	2018年	2019年	总计
性别
男	48	106	113	146	120	109	642
女	43	46	52	68	72	63	344
年龄组(岁)
0~ < 1	33	41	35	35	35	21	200
1~ < 2	26	52	40	75	66	54	313
2~ < 4	25	50	65	67	67	77	351
≥4	7	9	25	37	24	20	122
总计	91	152	165	214	192	172	986

下载: 导出CSV

表 2 原发性肠套叠患者的部分临床特征及继发性肠套叠患者的常见病因

Table 2. Partial clinical features of primary intussusception cases and common etiology of secondary intussusception cases

特征	例数(n)	比例(%)	特征	例数(n)	比例(%)
主要临床表现			手术患儿
腹痛或哭闹	686	69.57	Meckel憩室	20	50.00
呕吐	621	62.98	过敏性紫癜	6	15.00
血便	221	22.41	肠重复	4	10.00
腹部包块	356	36.11
发热	108	10.95

下载: 导出CSV

表 3 肠套叠例数与各气候因素之间的Poisson回归分析结果

Table 3. Results of Poisson regression analysis between intussusception cases and various climatic factors

自变量	β值	s_x	Z值	95% CI	P值
月降水量(mm)	＜0.001	0.001	0.330	0.999~1.001	0.741
月平均风速(m/s)	-0.433	0.180	-2.403	0.456~0.923	0.016
月平均气压(hPa)	-0.064	0.016	-3.998	0.909~0.968	＜0.001
月日照总量(h)	0.004	0.001	2.836	1.001~1.006	0.005
月平均气温(℃)	-0.066	0.016	-4.125	0.907~0.966	＜0.001
月平均相对湿度	0.008	0.009	0.801	0.989~1.027	0.423

下载: 导出CSV

参考文献(27)

[1]	Weisz B, Reif S, Spirer Z. Intussusception in infants [J]. Harefuah, 1994, 126(12): 704-707, 763.
[2]	Staatz G, Alzen G, Heimann G. Intestinal infection, the most frequent cause of invagination in childhood: results of a 10-year clinical study [J]. Klin Padiatr, 1998, 210(2): 61-64. DOI: 10.1055/s-2008-1043851.
[3]	Hsiao CC, Tsao LY, Lai CH. Nationwide population-based epidemiologic study of childhood and adulthood intussusception in Taiwan [J]. Pediatr Neonatol, 2013, 54(3): 188-193. DOI: 10.1016/j.pedneo.2013.01.004.
[4]	Guo WL, Zhang SF, Li JN, et al. Association of meteorological factors with pediatric intussusception in subtropical China: a 5-year analysis [J]. PLoS One, 2014, 9(2): e90521. DOI: 10.1371/journal.pone.0090521.
[5]	Tang XB, Hu DY, Mu XQ, et al. Association of air temperature with pediatric intussusception in northeastern China: a 10-year retrospective study [J]. Am J Emerg Med, 2021, 42: 211-216. DOI: 10.1016/j.ajem.2020.11.012.
[6]	Moore SW, Kirsten M, Müller EW, et al. Retrospective surveillance of intussusception in South Africa, 1998-2003 [J]. J Infect Dis, 2010, 202 Suppl: S156-S161. DOI: 10.1086/653563.
[7]	Jo DS, Nyambat B, Kim JS, et al. Population-based incidence and burden of childhood intussusception in Jeonbuk Province, South Korea [J]. Int J Infect Dis, 2009, 13(6): e383-e388. DOI: 10.1016/j.ijid.2009.01.011.
[8]	Justice F, Carlin J, Bines J. Changing epidemiology of intussusception in Australia [J]. J Paediatr Child Health, 2005, 41(9-10): 475-478. DOI: 10.1111/j.1440-1754.2005.00686.x.
[9]	Chouikha A, Fodha I, Maazoun K, et al. Rotavirus infection and intussusception in Tunisian children: implications for use of attenuated rotavirus vaccines [J]. J Pediatr Surg, 2009, 44(11): 2133-2138. DOI: 10.1016/j.jpedsurg.2009.05.003.
[10]	Hwang S, Kim J, Jung JY, et al. The epidemiology of childhood intussusception in South Korea: an observational study [J]. PLoS One, 2019, 14(12): e0219286. DOI: 10.1371/journal.pone.0219286.
[11]	Van Trang N, Le Nguyen NT, Dao HT, et al. Incidence and epidemiology of intussusception among infants in Ho Chi Minh City, Vietnam [J]. J Pediatr, 2014, 164(2): 366-371. DOI: 10.1016/j.jpeds.2013.10.006.
[12]	Xie XL, Wu Y, Wang Q, et al. Risk factors for recurrence of intussusception in pediatric patients: a retrospective study [J]. J Pediatr Surg, 2018, 53(11): 2307-2311. DOI: 10.1016/j.jpedsurg.2018.03.023.
[13]	Boudville IC, Phua KB, Quak SH, et al. The epidemiology of paediatric intussusception in Singapore: 1997 to 2004 [J]. Ann Acad Med Singap, 2006, 35(10): 674-679. doi: 10.47102/annals-acadmedsg.V35N10p674
[14]	Desai R, Curns AT, Patel MM, et al. Trends in intussusception-associated deaths among US infants from 1979-2007 [J]. J Pediatr, 2012, 160(3): 456-460. DOI: 10.1016/j.jpeds.2011.08.012.
[15]	Guo WL, Geng J, Zhan Y, et al. Forecasting and predicting intussusception in children younger than 48 months in Suzhou using a seasonal autoregressive integrated moving average model [J]. BMJ Open, 2019, 9(1): e024712. DOI: 10.1136/bmjopen-2018-024712.
[16]	Wu QB, Gu HY, Tang WG, et al. Distribution signature analysis between intussusception and rotavirus diarrhea in young children [J]. Zhonghua Shi Yan He Lin Chuang Bing Du Xue Za Zhi, 2008, 22(3): 216-218.
[17]	El-Hodhod MA, Nassar MF, El-Arab SE, et al. Rotavirus fecal antigen retrieval in infantile intussusception [J]. Eur J Clin Microbiol Infect Dis, 2008, 27(9): 879-881. DOI: 10.1007/s10096-008-0506-6.
[18]	Chen YE, Beasley S, Grimwood K, et al. Intussusception and rotavirus associated hospitalisation in New Zealand [J]. Arch Dis Child, 2005, 90(10): 1077-1081. DOI: 10.1136/adc.2005.074104.
[19]	Chang EJ, Zangwill KM, Lee H, et al. Lack of association between rotavirus infection and intussusception: implications for use of attenuated rotavirus vaccines [J]. Pediatr Infect Dis J, 2002, 21(2): 97-102. DOI: 10.1097/00006454-200202000-00003.
[20]	Khumjui C, Doung-ngern P, Sermgew T, et al. Incidence of intussusception among children 0-5 years of age in Thailand, 2001-2006 [J]. Vaccine, 2009, 27 Suppl 5: F116-F119. DOI: 10.1016/j.vaccine.2009.09.003.
[21]	Le Masne A, Lortat-Jacob S, Sayegh N, et al. Intussusception in infants and children: feasibility of ambulatory management [J]. Eur J Pediatr, 1999, 158(9): 707-710. DOI: 10.1007/s004310051184.
[22]	Rosie B, Dalziel S, Wilson E, et al. Epidemiology of intussusception in New Zealand pre-rotavirus vaccination [J]. N Z Med J, 2016, 129(1442): 36-45.
[23]	Jo S, Lim IS, Chae SA, et al. Characteristics of intussusception among children in Korea: a nationwide epidemiological study [J]. BMC Pediatr, 2019, 19(1): 211. DOI: 10.1186/s12887-019-1592-6.
[24]	Huppertz HI, Soriano-Gabarró M, Grimprel E, et al. Intussusception among young children in Europe [J]. Pediatr Infect Dis J, 2006, 25(1 Suppl): S22-S29. DOI: 10.1097/01.inf.0000197713.32880.46.
[25]	Awasthi S, Agarwal GG, Mishra V, et al. Four-country surveillance of intestinal intussusception and diarrhoea in children [J]. J Paediatr Child Health, 2009, 45(3): 82-86. DOI: 10.1111/j.1440-1754.2008.01434.x.
[26]	Chen SCC, Wang JD, Hsu HY, et al. Epidemiology of childhood intussusception and determinants of recurrence and operation: analysis of national health insurance data between 1998 and 2007 in Taiwan [J]. Pediatr Neonatol, 2010, 51(5): 285-291. DOI: 10.1016/S1875-9572(10)60055-1.
[27]	Jiang J, Jiang BM, Parashar U, et al. Childhood intussusception: a literature review [J]. PLoS One, 2013, 8(7): e68482. DOI: 10.1371/journal.pone.0068482.