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北京大学学报（医学版） ›› 2025, Vol. 57 ›› Issue (3): 584-591. doi: 10.19723/j.issn.1671-167X.2025.03.024

• 论著 • 上一篇    下一篇

2015—2021年宁波市6岁以下儿童热性惊厥的流行病学特征

刘光旭1, 张良2, 赵厚宇1, 邓思危1, 杨君婷1, 李宁2, 马瑞2, 何艳3, 许国章2, 刘志科1,*,*(), 詹思延1,*,*()   

  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. 宁波市疾病预防控制中心, 浙江宁波 315010
    3. 宁波市妇女儿童医院, 浙江宁波 315012
  • 收稿日期:2022-08-03 出版日期:2025-06-18 发布日期:2025-06-13
  • 通讯作者: 刘志科, 詹思延
  • 作者简介:

    * These authors contributed equally to this work

  • 基金资助:
    国家自然科学基金(91846303); 中国中医药循证医学中心研究室主任专项(2020YJSZX-2)

Epidemiological characteristics of febrile seizure among children under 6 years old in Ningbo City from 2015 to 2021

Guangxu LIU1, Liang ZHANG2, Houyu ZHAO1, Siwei DENG1, Junting YANG1, Ning LI2, Rui MA2, Yan HE3, Guozhang XU2, Zhike LIU1,*(), Siyan ZHAN1,*()   

  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
    3. Ningbo Women & Children's Hospital, Ningbo 315012, Zhejiang, China
  • Received:2022-08-03 Online:2025-06-18 Published:2025-06-13
  • Contact: Zhike LIU, Siyan ZHAN
  • Supported by:
    the National Natural Science Foundation of China(91846303); the Special Project for Director, China Center for Evidence Based Traditional Chinese Medicine(2020YJSZX-2)

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摘要：

目的: 探讨浙江省宁波市2015—2021年6岁以下儿童热性惊厥(febrile seizure，FS)发病的流行病学特征，分析新型冠状病毒感染对FS发病趋势的影响。方法: 基于宁波区域卫生信息平台，利用预防接种登记信息建立动态队列，通过电子病历的中文诊断术语“热性惊厥”“发热惊厥”“发热 & 惊厥”等，以及国际疾病分类第10版(International Classification of Diseases 10th revision, ICD-10)编码(R56.0)识别FS病例，在观察期间内FS发作并首次就诊定义为新发病例，发作间隔大于7 d为复发病例。采用Poisson分布估算发病密度的95%置信区间(confidence interval，CI)。结果: 2015年1月至2021年6月，累计纳入宁波市6岁以下儿童130.3万人，男性占52.87%，总随访人时为3 765 767.35人年，中位随访时间为2.83 (1.55~4.00)年。研究期间共有12 776例FS新发病例，男性多于女性，总发病密度为4.34 (95%CI: 4.27~4.40)/1 000人年，复发率为21.63%。男性、出生于宁波、非流动儿童FS的发病密度较高。相比于乡村和城乡结合部，城区FS的发病密度更高，且各区县间发病密度不同。儿童18~23月龄为发病密度高峰[8.42 (95%CI: 8.11~8.74)/1 000人年]；2015—2019年，发病密度逐年升高(Ptrend < 0.001)，最高为5.62 (95%CI: 5.43~5.81)/1 000人年，2020—2021年FS发病密度显著下降；冬季FS发病密度较高。结论: 2015—2019年宁波市6岁以下儿童FS的发病密度整体呈升高趋势，新型冠状病毒感染期间应更加注重高风险人群和高发地区FS的健康宣教与识别处置，减少其带来的疾病负担。

关键词: 热性惊厥, 发病密度, 流行特征, 动态队列, 儿童

Abstract:

Objective: To describe the epidemiological characteristics and changes of febrile seizure (FS) among children under 6 years old in Ningbo City, Zhejiang Province from 2015 to 2021. Methods: Based on the Ningbo Regional Health Information Platform, a dynamic cohort was established using vaccination registration information, and the cases of FS were identified by the diagnostic results of Chinese terms or International Classification of Diseases 10th revision (ICD-10) R56.0 code in the electronic medical records. The first visit of FS during the observation period was defined as a new case, and a recurrence case was defined as the case with a visit interval of more than 7 days. The 95% confidence interval (CI) of FS incidence density was calculated by the Poisson distribution. Results: From January 2015 to June 2020, there were 1.3 million children under 6 years old in Ningbo, with male accounting for 52.87%. The median follow-up time was 2.83 (1.55-4.00) years. During the follow-up period, 12 776 new onset cases had FS, with more males than females, with an overall incidence density of 4.34 (95%CI 4.27-4.40)/1 000 person-years and a recurrence rate of 21.63%. There was a higher incidence density in children who were male, born in Ningbo and of non-mobility. The incidence density of FS was higher in urban areas than in rural and rural-urban fringe areas, and the incidence density was different among districts and counties. The peak density was found in children aged 18-23 months [8.42 (95%CI 8.11-8.74)/1 000 person-years]. From 2015 to 2019, the incidence density increased with calendar year (Ptrend < 0.001), and the highest was 5.62 (95%CI 5.43-5.81) /1 000 person-years. The incidence density of FS decreased significantly during the period between 2020 and 2021. The incidence density was higher in winter. Conclusion: From 2015 to 2019, the overall incidence density of FS in children under 6 years old in Ningbo City presented an increasing trend. More attention should be paid to the health education, the improvement of the health maintenance model, the enhancement of the cognition of FS, the identification and treatment of FS among high-risk population and regions so as to prevent its recurrence and reduce the disease burden during the corona virus disease 2019 (COVID-19) epide-mic.

Key words: Febrile seizures, Incidence density, Epidemiological characteristics, Dynamic cohort, Children

中图分类号: 

  • R720.597

表1

2015—2021年宁波市6岁以下儿童一般人口学特征"

Characteristics variables Total (n=1 302 937) Non-FS children (n=1 290 161) FS children (n=12 776) U/χ2 a P
Follow-up/years, M (P25, P75) 2.83 (1.55, 4.00) 2.81 (1.55, 4.00) 3.97 (3.03, 4.84) 77.0b < 0.000 1
Gender, n (%) 414.7 < 0.000 1
    Female 614 075 (47.13) 609 179 (47.22) 4 878 (38.21)
    Male 688 855 (52.87) 680 957 (52.78) 7 898 (61.79)
Birth year, n (%) 3 721.3 < 0.000 1
    2009 52 503 (4.03) 52 474 (4.07) 29 (0.23)
    2010 97 372 (7.48) 97 180 (7.53) 192 (1.50)
    2011 114 688 (8.80) 114 165 (8.85) 523 (4.09)
    2012 127 890 (9.82) 126 776 (9.83) 1 114 (8.72)
    2013 123 135 (9.45) 121 577 (9.42) 1 558 (12.19)
    2014 139 110 (10.67) 136 920 (10.61) 2 190 (17.14)
    2015 124 730 (9.57) 122 794 (9.52) 1 936 (15.15)
    2016 135 426 (10.39) 133 393 (10.34) 2 033 (15.91)
    2017 124 524 (9.56) 122 843 (9.52) 1 681 (13.16)
    2018 103 732 (7.96) 102 772 (7.97) 960 (7.51)
    2019 93 662 (7.19) 93 178 (7.22) 484 (3.79)
    2020 66 165 (5.08) 66 089 (5.12) 76 (0.59)
City of birth, n (%) 756.6 < 0.000 1
    Ningbo outside 428 490 (32.88) 425 742 (33.00) 2 748 (21.51)
    Ningbo 873 107 (67.01) 863 094 (66.90) 10 013 (78.37)
    Missing 1 340 (0.10) 1 325 (0.10) 15 (0.12)
Mobility population, n (%) 167.9 < 0.000 1
    No 972 391 (74.63) 962 222 (74.58) 10 169 (79.59)
    Yes 330 546 (25.37) 327 939 (25.42) 2 607 (20.41)
Location, n (%) 95.0 < 0.000 1
    Urban 763 701 (58.61) 755 716 (58.58) 7 985 (62.5)
    Urban-rural fringe 309 936 (23.79) 307 319 (23.82) 2 617 (20.48)
    Rural 227 820 (17.49) 225 661 (17.49) 2 159 (16.90)
    Missing 1 480 (0.11) 1 465 (0.11) 15 (0.12)
District, n (%) 903.4 < 0.000 1
    Yuyao 171 664 (13.17) 170 314 (13.2) 1 350 (10.57)
    Beilun 128 216 (9.84) 126 985 (9.84) 1 231 (9.64)
    Fenghua 66 982 (5.14) 65 952 (5.11) 1 030 (8.06)
    Ninghai 98 411 (7.55) 97 627 (7.57) 784 (6.14)
    Cixi 251 111 (19.27) 249 186 (19.31) 1 925 (15.07)
    Jiangbei 69 471 (5.33) 68 738 (5.33) 733 (5.74)
    Haishu 90 916 (6.98) 89 920 (6.97) 996 (7.8)
    Xiangshan 70 338 (5.40) 69 900 (5.42) 438 (3.43)
    Yinzhou 271 894 (20.87) 268 861 (20.84) 3 033 (23.74)
    Zhenhai 77 081 (5.92) 75 858 (5.88) 1 223 (9.57)
    Missing 6 853 (0.53) 6 820 (0.53) 33 (0.26)

表2

2015—2021年宁波市6岁以下儿童FS发病密度的人群分布特征"

Variable Number of FS episodes, n (%)a Follow-up(/person-years) Incidence density (95%CI)(/1 000 person-years)
Total 16 326 (100.00) 3 765 767.35 4.34 (4.27-4.40)
Gender
    Female 6 134 (37.57) 1 776 810.55 3.24 (3.13-3.35)
    Male 10 192 (62.43) 1 988 941.25 4.75 (4.67-4.84)
Birth city
    Ningbo outside 3 361 (21.59) 1 038 704.37 3.24 (3.13-3.35)
    Ningbo 12 944 (79.28) 2 722 824.45 4.75 (4.67-4.84)
Mobility population
    No 13 072 (80.06) 2 796 648.95 4.67 (4.59-4.76)
    Yes 3 254 (19.94) 969 118.40 3.36 (3.24-3.48)

图1

2015—2021年宁波市6岁以下儿童FS发病密度的年龄分布特征"

表3

2015—2021年宁波市6岁以下儿童FS发病密度的地区分布特征"

Location Number of FS episodes, n (%) Follow-up(/person-years) Incidence density (95%CI)(/1 000 person-years)
Urban 10 329 (63.33) 2 224 472.86 4.64 (4.55-4.73)
Urban-rural fringe 3 289 (20.16) 891 344.26 3.69 (3.57-3.82)
Rural 2 692 (16.51) 646 612.06 4.16 (4.01-4.32)

图2

2015—2021年宁波市6岁以下儿童FS发病密度的地区分布示意图(/1 000人年)"

图3

2015—2021年宁波市6岁以下儿童FS发病密度的时间分布"

图4

2015—2020年宁波市6岁以下儿童FS发病的时间分布"

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