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北京大学学报（医学版） ›› 2021, Vol. 53 ›› Issue (3): 485-490. doi: 10.19723/j.issn.1671-167X.2021.03.008

• 论著 • 上一篇    下一篇

2015—2019年宁波市0~36月龄婴幼儿癫痫发病的流行病学研究

姚晓莹1,刘志科1,李宁2,马瑞2,赵薛飞2,张良2,许国章2,詹思延1,Δ(),方挺2,Δ()   

  1. 1.北京大学公共卫生学院流行病与卫生统计学系, 北京 100191
    2.宁波市疾病控制与预防中心, 浙江宁波 315010
  • 收稿日期:2021-02-05 出版日期:2021-06-18 发布日期:2021-06-16
  • 通讯作者: 詹思延,方挺 E-mail:siyan-zhan@bjmu.edu.cn;fangt@nbcdc.org.cn
  • 基金资助:
    国家自然科学基金(81973146)

Epidemiological study of infantile epilepsy incidence density among infants under 36 months of age in Ningbo City from 2015 to 2019

YAO Xiao-ying1,LIU Zhi-ke1,LI Ning2,MA Rui2,ZHAO Xue-fei2,ZHANG Liang2,XU Guo-zhang2,ZHAN Si-yan1,Δ(),FANG Ting2,Δ()   

  1. 1. Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China
    2. Ningbo Municipal Center for Disease Control and Prevention, Ningbo 315010, Zhejiang, China
  • Received:2021-02-05 Online:2021-06-18 Published:2021-06-16
  • Contact: Si-yan ZHAN,Ting FANG E-mail:siyan-zhan@bjmu.edu.cn;fangt@nbcdc.org.cn
  • Supported by:
    National Natural Science Foundation of China(81973146)

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摘要：

目的: 描述浙江省宁波市0~36月龄婴幼儿癫痫发病的三间分布及其变化趋势。方法: 采用出生队列设计,回顾性收集2015—2019年宁波市全民健康信息平台中本地出生的婴幼儿,以平台内电子病历首次癫痫就诊作为新发病例。采用泊松分布估算癫痫发病密度及其95%CI。结果: 2015—2019年宁波市累计出生29.49万儿童,男性占51.92%,总人年59.53万,中位随访人年2.31年[四分位距(interquartile range, IQR):1.90]。观察期间癫痫新发575例,总就诊人次2 599,平均就诊人次4.52,总发病密度96.59/10万人年(95%CI:88.85~104.82)。中位发病月龄13月龄(IQR:15),0~12月龄发病密度最高(102.18/10万人年),25~36月龄最低(89.68/10万人年),差异无统计学意义(P>0.05)。男性发病密度97.58/10万人年,女性95.53/10万人年,差异无统计学意义(P>0.05)。下辖10个区县中,奉化最高(130.54/10万人年,95%CI:94.47~175.83),宁海最低(66.44/10万人年,95%CI:47.02~91.19), 差异有统计学意义(P<0.05)。不同出生年份发病差异无统计学意义(P>0.05)。不同日历年0~12月龄发病密度差异有统计学意义(Ptrend<0.05)。该年龄组下, 2015年发病密度最低(69.41/10万人年,95%CI:41.79~108.39), 2019年最高(225.61/10万人年,95%CI:186.10~271.03)。不同日历年13~24、25~36月龄发病密度差异无统计学意义(P>0.05)。结论: 2015—2019年宁波市0~36月龄婴幼儿癫痫发病密度整体较低,年龄组、性别、出生年份等发病密度差异均无统计学意义,0~12月龄婴幼儿发病密度随年份呈递增趋势。

关键词: 癫痫, 出生队列, 发病密度, 流行病学研究, 婴儿

Abstract:

Objective: To describe the distribution and trend of infantile epilepsy among infants under 36 months in Ningbo, Zhejiang Province. Methods: Using the birth cohort design, we retrospectively collected the local born infants in Ningbo national health information platform from 2015 to 2019, and took the first visit of epilepsy in the electronic medical record of the platform as the new case. The incidence density and 95% confidence interval (CI) of epilepsy were estimated by Poisson distribution. Results: From 2015 to 2019, a total of 294 900 children were born in Ningbo, with male accounting for 51.92%. The total person-years of observation were 595 300, while the median follow-up person-years was 2.31 [interquartile range (IQR): 1.90]. There were 575 new onset epilepsy patients during the whole observation period. The total number of visits was 2 599, with an average of 4.52. The total incidence density was 96.59/100 000 person-years (95%CI: 88.85-104.82). The median age of onset was 13 months (IQR: 15), 0-12 months old infants had the highest incidence density (102.18/100 000 person-years), 25-36 months old infants had the lowest incidence density (89.68/100 000 person-years), and the difference was not statistically significant (P>0.05). The incidence density of male was 97.58/100 000 person-years, female was 95.53/100 000 person-years, and the difference was not statistically significant (P>0.05). Fenghua was the highest (130.54/100 000 person-years, 95%CI: 94.47-175.83) and Ninghai was the lowest (66.44/100 000 person-years, 95%CI: 47.02-91.19), with significant difference (P<0.05). There was no significant difference in the incidence density in different birth years (P>0.05). There was significant difference in the incidence density between 0-12 months old infants in different calendar years (Ptrend<0.05). In this age group, the incidence density was the lowest in 2015 (69.41/100 000 person-years, 95%CI: 41.79-108.39), and the highest in 2019 (225.61/100 000 person-years, 95%CI: 186.10-271.03). There was no significant difference in the incidence density between 13-24 and 25-36 months old infants in different calendar years (P>0.05). Conclusion: The incidence density of epilepsy in 0-36 months old infants in Ningbo City from 2015 to 2019 was low as a whole, and there was no difference in age group, gender, and year of birth. The incidence density of 0-12 months old infants increased with the year.

Key words: Epilepsy, Birth cohort, Incidence density, Epidemiologic study, Infant

中图分类号: 

  • R181.32

表1

2015—2019年宁波市0~36月龄本地出生婴幼儿一般人口学特征 [n (%)]"

Variable Total (n=294 938) Male (n=153 137) Female (n=141 801) χ2 P valuea
Person-years 595 307.70 (100.00) 308 476.90 (51.82) 286 830.80 (48.18)
Birth yearb 9.25 >0.05
2015 56 373 (19.11) 29 381 (19.19) 26 992 (19.04)
2016 64 363 (21.82) 33 264 (21.72) 31 099 (21.93)
2017 62 685 (21.25) 32 634 (21.31) 30 051 (21.19)
2018 55 317 (18.76) 28 490 (18.60) 26 827 (18.92)
2019 56 200 (19.05) 29 368 (19.18) 26 832 (18.92)
Birth seasonc 4.82 >0.05
Spring 70 407 (23.87) 36 527 (23.85) 33 880 (23.89)
Summer 73 953 (25.07) 38 457 (25.11) 35 496 (25.03)
Autumn 79 651 (27.01) 41 547 (27.13) 38 104 (26.87)
Winter 70 927 (24.05) 36 606 (23.90) 34 321 (24.20)
Area 36.20 <0.05
Yinzhou 66 036 (22.39) 34 278 (22.38) 31 758 (22.40)
Cixi 40 635 (13.78) 20 916 (13.66) 19 719 (13.91)
Yuyao 35 399 (12.00) 18 448 (12.05) 16 951 (11.95)
Haishu 30 850 (10.46) 15 985 (10.44) 14 865 (10.48)
Ninghai 28 549 (9.68) 15 230 (9.95) 13 319 (9.39)
Beilun 26 062 (8.84) 13 376 (8.73) 12 686 (8.95)
Zhenhai 18 984 (6.44) 9 746 (6.36) 9 238 (6.51)
Xiangshan 17 096 (5.80) 8 880 (5.80) 8 216 (5.79)
Fenghua 16 062 (5.44) 8 413 (5.49) 7 639 (5.39)
Jiangbei 15 233 (5.16) 7 843 (5.12) 7 390 (5.21)
Missing 42 (0.01) 22 (0.01) 20 (0.01)

表2

2015—2019年0~36月龄婴幼儿癫痫首次发病病例的人口学特征"

Variable Total (n=575) Male (n=301) Female (n=274)
Month onset/months, M (IQR) 13 (15) 15 (16) 11 (14)
Age group onset, n(%)
0-12 months 282 (49.04) 133 (44.19) 149 (54.38)
13-24 months 178 (30.96) 103 (34.22) 75 (27.37)
25-36 months 115 (20.00) 65 (21.59) 50 (18.25)
Calendar year onset, n(%)
2015 19 (3.30) 8 (2.66) 11 (4.01)
2016 72 (12.52) 36 (11.96) 36 (13.14)
2017 165 (28.70) 86 (28.57) 79 (28.83)
2018 165 (28.70) 83 (27.57) 82 (29.93)
2019 154 (26.78) 88 (29.24) 66 (24.09)

图1

2015—2019年0~36月龄婴幼儿癫痫发病密度地区特征示意图(/10万人年)"

表3

2015—2019年0~36月龄婴幼儿癫痫发病密度人群分布特征(/10万人年)"

Variable Incidence density (95%CI)
Total 96.59 (88.85, 104.82)
Gender
Male 97.58 (86.86, 109.25)
Female 95.53 (84.55, 107.53)
Age group
0-12 months 102.18 (90.60, 114.83)
13-24 months 93.14 (79.96, 107.88)
25-36 months 89.68 (74.04, 107.65)

表4

2015—2019年0~36月龄婴幼儿癫痫发病密度时间特征(/10万人年)"

Age group/
months		 Birth year, incidence density (95%CI) Ptrend
2015 2016 2017 2018 2019
0-12 85.57
(62.87, 113.78)		 115.78
(90.75, 145.57)		 114.12
(88.96, 144.18)		 136.89
(107.49, 171.86)		 65.86
(39.03, 104.09)a		 >0.05
13-24 99.18
(74.07, 130.06)		 93.94
(71.15, 121.70)		 84.78
(62.92, 111.77)		 75.03
(45.18, 117.17)b		 >0.05
25-36 102.46
(76.52, 134.36)		 69.71
(50.02, 94.56)		 79.51
(49.83, 120.37)c		 >0.05
Age group/
months		 Calendar year, incidence density (95%CI) Ptrend
2015 2016 2017 2018 2019
0-12 69.41
(41.79, 108.39)		 89.39
(66.56, 117.53)		 130.01
(103.55, 161.16)		 174.68
(142.28, 212.25)		 225.61
(186.10, 271.03)		 <0.05
13-24 80.70
(49.96, 123.37)		 106.07
(80.54, 137.12)		 92.84
(70.32, 120.28)		 75.28
(54.25, 101.75)		 >0.05
25-36 127.54
(87.24, 180.05)		 73.63
(52.36, 100.66)		 70.13
(50.96, 94.14)		 >0.05
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