Yasunaga Hideo, Shi Yongjin, Takeuchi Masato, Horiguchi Hiromasa, Hashimoto Hideki, Matsuda Shinya, Ohe Kazuhiko
Department of Health Management and Policy, Graduate School of Medicine, The University of Tokyo, Tokyo.
Intern Med. 2010;49(18):1965-70. doi: 10.2169/internalmedicine.49.3843. Epub 2010 Sep 15.
In the present study we aim to describe the clinical features and related complications of severe measles requiring hospitalization in Japan in 2007 and 2008.
We extracted the records of patients diagnosed with measles between July and December in 2007 and 2008 from the Diagnosis Procedure Combination (DPC) inpatient database and the verified age distribution of patients with measles requiring hospitalization and the rate of measles-related complications. We also examined the rate of measles patients who were pregnant or had malignancies.
We identified 1,037 inpatients in 377 hospitals; 879 in 2007 and 158 in 2008. Overall, 554 (53.4%) were male. Patient age distribution showed two peaks; ≤4 years (21%) and 15-29 years (45%). Ninety (8.7%) patients had pneumonia, 22 (2.1%) had encephalitis, 7 (0.7%) had intestinal complications, 7 (0.7%) had conjunctivitis, 6 (0.6%) had meningitis, and 4 (0.4%) had otitis media. Patients aged ≤14 years were significantly more likely to have pneumonia (16.4%; p<0.001). The rate of encephalitis was relatively low in patients aged ≤14 years (0.9%) compared with those aged 15-29 years (3.0%) and those aged ≥30 years (2.0%); the difference was not statistically significant (p=0.141). Of 31 pregnant women, 10 had spontaneous abortion or stillbirth. Twenty-eight patients had malignancies.
The present study adds important information to our knowledge of the clinical features of severe measles. Follow-up monitoring of the trends of this distressing disease using the DPC database will be essential.
在本研究中，我们旨在描述2007年和2008年在日本因严重麻疹而需住院治疗的临床特征及相关并发症。
我们从诊断程序组合（DPC）住院患者数据库中提取了2007年7月至12月以及2008年期间被诊断为麻疹的患者记录，核实了需住院治疗的麻疹患者的年龄分布以及麻疹相关并发症的发生率。我们还调查了怀孕或患有恶性肿瘤的麻疹患者的比例。
我们在377家医院中确定了1037名住院患者；2007年有879名，2008年有158名。总体而言，554名（53.4%）为男性。患者年龄分布呈现两个高峰；≤4岁（21%）和15 - 29岁（45%）。90名（8.7%）患者患有肺炎，22名（2.1%）患有脑炎，7名（0.7%）有肠道并发症，7名（0.7%）有结膜炎，6名（0.6%）有脑膜炎，4名（0.4%）有中耳炎。年龄≤14岁的患者患肺炎的可能性显著更高（16.4%；p<0.001）。与15 - 29岁（3.0%）和≥30岁（2.0%）的患者相比，年龄≤14岁的患者脑炎发生率相对较低（0.9%）；差异无统计学意义（p = 0.141）。31名孕妇中，10名发生自然流产或死产。28名患者患有恶性肿瘤。
本研究为我们了解严重麻疹的临床特征增添了重要信息。利用DPC数据库对这种令人痛苦的疾病的趋势进行后续监测至关重要。
