中国全身性感染的流行病学研究

doi:10.3969/j.issn.1006-7795.2018.01.002

首都医科大学学报 ›› 2018, Vol. 39 ›› Issue (1): 6-8.doi: 10.3969/j.issn.1006-7795.2018.01.002

中国全身性感染的流行病学研究

杜斌, 翁利

中国危重病医学临床研究协作组, 北京协和医院内科重症监护病房, 北京 100730

收稿日期:2017-11-13 出版日期:2018-01-21 发布日期:2018-01-27
通讯作者: 杜斌 E-mail:dubin98@gmail.com
基金资助:
首都临床特色应用研究（Z131107002213112），中国医学科学院创新工程基金（2016-I2M-1-014）。

Epidemiology of sepsis in China

Du Bin, Weng Li

China Critical Care Clinical Trials Group, Medical Intensive Care Unit, Peking Union Medical College Hospital, Beijing 100730, China

Received:2017-11-13 Online:2018-01-21 Published:2018-01-27
Supported by:
This study was supported by Capital Clinical Application Research Grant (Z1311017002213112), Chinese Academy of Medical Sciences (CAMS) Innovation Fund for Medical Sciences (CIFMS) (2016-I2M-1-014).

摘要/Abstract

摘要： 全身性感染是重症监护病房（intensive care unit，ICU）患者的首要死因。中国的研究显示，外科ICU及综合ICU严重全身性感染的罹患率分别为8.7%和37.3%，与欧洲国家相似。然而，多达86%的全身性感染患者在普通病房接受治疗，因此，基于ICU的流行病学研究可能低估了全身性感染罹患率。对北京市月坛街道所有成年住院患者进行的队列研究显示，全身性感染标化发病率为461例/10万人口，相当于全国每年新发病例486万例。另外，基于全国疾病监测系统死因监测系统的研究显示，2015年所有死亡患者中14.5%由重症感染引起，相当于标化病死率76.8例/10万人口，或超过100万例。另外，对33例全身性感染存活患者的长期预后研究显示，其生活质量降低可持续6年之久。以上结果提示，中国全身性感染的疾病负担非常严重，这对于制定相关卫生政策，合理配置有限的医疗资源以及采取有效的预防措施至关重要。

关键词: 全身性感染, 流行病学, 发病率, 患病率, 病死率

Abstract: As the leading cause of death in intensive care unit (ICU) patients, epidemiology of sepsis remains poorly understood until the recent years.The prevalence of severe sepsis was reported as 8.7% in critically ill patients in surgical ICUs, and 37.3% in general ICUs, with the latter similar to the average prevalence of sepsis in European ICUs. However, ICU-based prevalence of sepsis was prone to underestimation, as up to 86% of septic patients might be managed in general wards rather than in ICU. Population-based epidemiology of sepsis was studied in only one cohort study of all hospitalized adults in a subdistrict of Beijing, which reported the standardized incidence of sepsis as 461 cases per 100 000 population, corresponding to 4.86 million cases per year in China. In addition, based on National Mortality Surveillance System, the preliminary data from an ongoing study showed that 14.5% of all deaths was attributable to infection, corresponding to standardized mortality of 76.8 deaths per 100 000 population, or more than 1 million deaths in 2015. Moreover, data on long-term outcomes were available for only 33 sepsis survivors, which suggested lower quality of life during a follow-up of up to 6 years. The above data suggested that the disease burden of sepsis was high in China, which was important for the design of relevant health care policies, allocation of limited health resources, and development of prevention measurements.

Key words: sepsis, epidemiology, incidence, prevalence, fatality

中图分类号:

杜斌, 翁利. 中国全身性感染的流行病学研究[J]. 首都医科大学学报, 2018, 39(1): 6-8.

Du Bin, Weng Li. Epidemiology of sepsis in China[J]. Journal of Capital Medical University, 2018, 39(1): 6-8.

参考文献

[1] Cohen J, Vincent J L, Adhikari N K, et al. Sepsis:a roadmap for future research[J]. Lancet Infect Dis, 2015,15(5):581-614.
[2] Shankar-Hari M, Phillips G S, Levy M L, et al. Developing a new definition and assessing new clinical criteria for septic shock:for the third international consensus definition for sepsis and septic shock (sepsis-3)[J]. JAMA, 2016, 315(8):801-810.
[3] Martin G S, Mannino D M, Eaton S, et al. The epidemiology of sepsis in the united states from 1979 through 2000[J]. N Engl J Med, 2003, 348:1546-1554.
[4] Walkey A J, Lagu T, Lindenauer P K. Trends in sepsis and infection sources in the united states. A population-based study[J]. Ann Am Thorac Soc, 2015, 12(2):216-220.
[5] Seymour C W, Rea T D, Kahn J M, et al. Severe sepsis in pre-hospital emergency care:analysis of incidence, care, and outcome[J]. Am J Respir Crit Care Med, 2012, 186(12):1264-1271.
[6] Fleischmann C, Scherag A, Adhikari N K, et al. Assessment of global incidence and mortality of hospital-treated sepsis. Current estimates and limitations[J]. Am J Respir Crit Care Med, 2016, 193(3):259-272.
[7] Bone R C, Balk R A, Cerra F B, et al. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis[J]. Chest, 1992,101(6):1644-1655.
[8] Cheng B, Xie G, Yao S, et al. Epidemiology of severe sepsis in critically ill surgical patients in ten university hospitals in China[J]. Crit Care Med, 2007,35(11):2538-2546.
[9] Zhou J, Qian C, Zhao M, et al. Epidemiology and outcome of severe sepsis and septic shock in intensive care units in mainland China[J]. PLoS One, 2014,9(9):e107181.
[10] Vincent J L, Sakr Y, Sprung C L, et al. Sepsis in European intensive care units:results of the SOAP study[J]. Crit Care Med, 2006, 34(2):344-353.
[11] Angus D C, Linde-Zwirble W T, Lidicker J, et al. Epidemiology of severe sepsis in the united states:analysis of incidence, outcome, and associated costs of care[J]. Crit Care Med, 2001, 29(7):1303-1310.
[12] Esteban A, Frutos-Vivar F, Ferguson N D, et al. Sepsis incidence and outcome:contrasting the intensive care unit with the hospital ward[J]. Crit Care Med, 2007, 35(5):1284-1289.
[13] Zhou J, Tian H, Du X, et al. Population-based epidemiology of sepsis in a subdistrict of Beijing[J]. Crit Care Med, 2017, 45(7):1168-1176.
[14] 中华人民共和国国家统计局. 2014年国民经济和社会发展统计公报[EB/OL].[2017-11-13]. http://www.stats.gov.cn/tjsj/zxfb/201502/t20150226_685799.html.
[15] Liu S, Wu X, Lopez A D, et al. An integrated national mortality surveillance system for death registration and mortality surveillance, China[J]. Bull World Health Organ, 2016, 94(1):46-57.
[16] Yende S, Angus D C. Long-term outcomes from sepsis[J]. Curr Infect Dis Rep, 2007, 9(5):382-386.
[17] Herridge M S, Cheung A M, Tansey C M, et al. One-year outcomes in survivors of the acute respiratory distress syndrome[J]. N Engl J Med, 2003, 348(8):683-693.
[18] Iwashyna T J, Angus D C. Declining case fatality rates for severe sepsis:good data bring good news with ambiguous implications[J]. JAMA, 2014,311(13):1295-1297.
[19] Angus D C. The lingering consequences of sepsis:a hidden public health disaster?[J]. JAMA, 2010, 304(16):1833-1834.

中国全身性感染的流行病学研究

Epidemiology of sepsis in China

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