哮喘联盟

   摘要
   目的：我们旨在报道1960年～2011年期间英国的百日咳住院率趋势；并为近期英国百日咳杆菌的异常活动提供研究背景。
   方法：对英国国立医院住院统计信息(HES, 1968-2011)和牛津档案连锁研究(ORLS, 1963～2011)记录的百日咳住院医院患者进行回顾性分析。分为英国和牛津档案连锁研究两个区域。主要观察指标为25岁以下各年龄段的年龄和性别特异性每10万人住院率，并总结年龄和性别的标准化率。
   结果：从20世纪60年代到70年代初，住院率不断下降。例如，英国1968年的每10万人标准化率为12.8（95%可信区间为11.2-14.5），而1973年每10万人住院率为4.0（3.0-4.9）。到1978年和1982年他们又分别增加到每10万人45.0 (41.4-48.6)和47.4 (43.7-51.1)。从20世纪80年代末，住院率持续下降，2003年-2011年期间每年都降到每10万人1-4之间。虽然通报病例数紧跟住院率趋势，但两者每年的比值并不一致，近10年来通报病例数与住院数的比值范围为1.07 (95% 可信区间为1.00-1.14) 到4.03 (3.79-4.27) 。
   结论：20世纪70年代末到80年代初百日咳的流行与高住院率显著相关。历史比较表明目前住院率低。必须全面实行疫苗预防项目，以提高对百日咳活动的控制。
 

（刘国梁 审校）
J R Soc Med. 2014 Feb 13. [Epub ahead of print]

 

Trends in hospital admission rates for whooping cough in England across five decades: database studies.
 

Haslam N, Hoang U, Goldacre MJ.
 

ABSTRACT
OBJECTIVES：Our aim was to report on trends in hospitalisation rates for pertussis in England from the 1960s to 2011; and to provide context for the recent unexpected activity of Bordetella pertussis in the UK.
DESIGN：A retrospective analysis of English national Hospital Episode Statistics (HES, 1968-2011) and the Oxford Record Linkage Study (ORLS, 1963-2011) for people admitted to hospital with whooping cough.SettingEngland and the Oxford Record Linkage Study area.Main outcome measuresAge- and gender-specific hospital admission rates, and summary age- and sex-standardised rates, for people aged under 25 years per 100,000 population in each age group.
RESULTS：Admission rates declined from the 1960s to the early 1970s. For example, the standardised rates were 12.8 (95% confidence interval 11.2-14.5) per 100,000 in England in 1968 and 4.0 (3.0-4.9) per 100,000 in 1973. They then increased to reach 45.0 (41.4-48.6) per 100,000 in 1978 and 47.4 (43.7-51.1) in 1982. From the late 1980s, admission rates continued to decline, falling to between 1 and 4 per 100,000 in each of the years between 2003 and 2011. While the trend in hospital admissions closely followed that in notifications, the annual ratio between these two measures was not consistent ranging from 1.07 (95% confidence interval 1.00-1.14) to 4.03 (3.79-4.27) notifications per admission over the last 10 years.
CONCLUSIONS：Epidemics of whooping cough in the late 1970s and early 1980s were associated with a significant rise in hospital admission rates. Current admission rates are low, by historical comparison. Vaccine programmes must continue to be fully implemented in order to improve control of pertussis activity.
 

J R Soc Med. 2014 Feb 13. [Epub ahead of print]