杩戞棩锛岄挓鍗楀北闄㈠＋鍦ㄦ帴鍙楅噰璁挎椂琛ㄧず锛屾鏃舵垜鍥戒篃澶勪簬鍐娴佹劅楂樺彂鏈燂紝杩戞湡鍑虹幇鍙戠儹鐨勫師鍥犱笉鍗曠函鏄劅鏌撴柊鍐狅紝涔熸湁涓嶅皯鏄祦鎰燂紝鏈夊皯鏁颁汉鍙兘鏄弻閲嶆劅鏌撱€備笉浠呭姝わ紝鏃╁湪浠婂勾 8 鏈堬紝涓柧鎺т笓瀹跺氨鏇剧爺鍒わ紝浠婂勾绉嬪啲瀛ｅ彲鑳藉嚭鐜版祦鎰熷拰鏂板啝鑲虹値鍙犲姞娴佽鐨勯闄┿€?/p>
鏂板啝鍜屾祦鎰熺殑鍙犲姞娴佽锛屼細缁欑柅鎯呭甫鏉ュ摢浜涘彉鍖栵紵鍙岄噸鎰熸煋锛屽張浼氱粰鎮ｈ€呴€犳垚鎬庢牱鐨勫奖鍝嶏紵
鏂板啝+娴佹劅锛氫粖鍐彔鍔犳祦琛岄闄╅珮
涓嶅悓浜庢垜浠父璇寸殑銆佺棁鐘惰緝杞荤殑鎰熷啋锛屾祦琛屾€ф劅鍐掞紙influenza锛屾祦鎰燂級鏄竴绉嶇敱娴佹劅鐥呮瘨寮曡捣鐨勬€ユ€у懠鍚搁亾浼犳煋鐥咃紝鐢变簬娴佹劅鐥呮瘨鎶楀師鎬ф槗鍙橈紝浼犳挱杩呴€燂紝鍥犳姣忓勾鍙紩璧峰鑺傛€ф祦琛岋紝瀹规槗鍦ㄥ鏍°€佹墭骞兼満鏋勫拰鍏昏€侀櫌绛変汉缇よ仛闆嗙殑鍦烘墍鍙戠敓鏆村彂鐤儏銆?/p>
姣忓勾锛屽鑺傛€ф祦鎰熸祦琛屽湪鍏ㄧ悆鍙鑷?6500 涓囷綖1.9 浜夸汉鎰熸煋锛屽苟瀵艰嚧 300锝?00 涓囬噸鐥囩梾渚嬪拰 29锝?5 涓囧懠鍚搁亾鐤剧梾鐩稿叧姝讳骸銆?/strong>鍏朵腑瀛曞銆佸┐骞煎効銆佽€佸勾浜哄拰鎱㈡€у熀纭€鐤剧梾鎮ｈ€呯瓑楂樺嵄浜虹兢锛屽嚭鐜颁弗閲嶇柧鐥呭拰姝讳骸鐨勯闄╄緝楂樸€?/p> 鑰屽湪浠婂勾锛屾柊鍐犳祦鎰熷彔鍔犳祦琛岀殑瓒嬪娍鍦ㄦ娲茬瓑鍥藉凡缁忓憟鐜板嚭杈冧负涓ュ郴鐨勬€佸娍銆傛嵁寰峰浗濯掍綋 12 鏈?20 鏃ユ姤閬擄紝寰峰浗 Robert Koch 鐮旂┒鎵€鐩戞祴鍒帮紝浠婂勾鍐寮€濮嬬殑鎰熸煋娴疆涓紝鏂板啝鐥呮瘨鍙彂鎸ヤ簡娆¤浣滅敤锛屽湪鏈€杩戝嚑鍛ㄧ殑鏍锋湰鍒嗘瀽涓秴杩囦竴鍗婂彲浠ユ娴嬪埌娴佹劅鐥呮瘨銆?/strong> 浠?WHO 鐩戞祴鏁版嵁鍙互鐪嬪埌锛屾埅鑷?2022 骞?12 鏈?26 鏃ワ紝娴佹劅鐥呮瘨鐨勬祦琛屽湪浠婂啲鏈夋樉钁楀闀匡紝鏂板啝娴佹劅鍙犲姞娴佽鐨勮秼鍔垮崄鍒嗘槑鏄俱€?/p> 
鍥炬簮锛氬弬鑰冭祫鏂?1
2020 骞达紝鏉ヨ嚜缇庡浗鏅灄鏂】澶у鐨勪竴椤瑰缓妯＄爺绌舵寚鍑猴紝淇濇寔绀句氦璺濈绛夋柊鍐犵柅鎯呯殑闈炶嵂鐗╁共棰勬帾鏂斤紙NPI锛夊湪鍑忓皯鏂板啝浼犳挱鐨勫悓鏃讹紝涔熷噺灏戜簡娴佹劅鐥呮瘨銆佸懠鍚搁亾鍚堣優鐥呮瘨锛圧SV锛夌殑浼犳挱锛?strong>浣嗗悓鏃讹紝NPI 涔熶細瀵艰嚧浜虹兢涓娴佹劅鍜?RSV 鐥呮瘨鏄撴劅鐨勭兢浣撴瘮渚嬬疮璁′笂鍗囷紝鍥犳锛屽湪闀挎湡瀹炴柦 NPI 鍚庯紝鍙兘浼氶潰涓存祦鎰熷拰 RSV 澶ц妯℃祦琛岀殑椋庨櫓銆?/strong>[2]
2022 骞?8 鏈堬紝涓浗鐤炬帶涓績鐥呮瘨瀛﹂甯笓瀹惰懀灏忓钩鍦ㄥ彂甯冧細涓婅〃绀猴紝浠婂勾澶忓ぉ锛屾垜鍥藉崡鏂瑰凡缁忓嚭鐜颁簡 A锛圚3N2锛変簹鍨嬫祦鎰熺梾姣掔殑娴佽楂樺嘲锛屼粖骞寸鍐鍑虹幇杈冮珮姘村钩鐨勬祦鎰熸祦琛岄闄╁亸楂樸€?/p>
钁ｅ皬骞虫寚鍑猴紝2020锝?021 骞村害锛屾垜鍥芥祦鎰熷憟浣庢按骞崇殑娴佽鐘舵€侊紝杩欐槸鐢变簬閲囧彇浜嗙浉瀵规瘮杈冧弗鏍肩殑鍏叡鍗敓鎺柦鏉ラ闃叉柊鍐狅紝浣嗕粠鍙﹀涓€涓搴︾湅锛?strong>闀挎湡鐨勪綆姘村钩娴佽锛岃嚜鐒舵劅鏌撶殑浜虹兢姣斾緥灏变細鍋忎綆锛屽姞涓婃垜鍥芥祦鎰熺柅鑻楃殑鎺ョ涓€鐩村浜庢瘮杈冧綆鐨勭姸鎬侊紝鎵€浠ュ湪浜虹兢褰撲腑瀵规祦鎰熺梾姣掗瀛樼殑鍏嶇柅鍔涜偗瀹氫細鏈夋墍涓嬮檷銆?/strong>
涓浗鍖昏嵂鏁欒偛瀛︿細鍚嶈獕浼氶暱銆佽憲鍚嶅懠鍚哥梾涓撳鍒樺張瀹佹暀鎺堣涓猴紝浠婂啲鐨勬祦鎰熸祦琛屾儏鍐碉紝鍙栧喅浜庢祦鎰熺柅鑻楁帴绉嶇殑鎯呭喌銆傘€屽鏋滈珮鍗变汉缇ょ殑娴佹劅鐤嫍鎺ョ瓒冲锛屾祦鎰熺殑鍙戠梾灏变笉浼氬緢澶氥€傚彟澶栵紝娴佹劅鍜屾柊鍐犵殑棰勯槻鎺柦鍑犱箮鏄悓鏍风殑锛屼繚鎸佺ぞ浜よ窛绂汇€佸嫟娲楁墜浣╂埓鍙ｇ僵绛夌瓑锛屾柊鍐犱互鏉ュぇ瀹跺熀鏈笂閮藉吇鎴愪簡杩欐牱鐨勯槻鎶や範鎯紝杩欏嚑骞存祦鎰熺殑鍙戠梾鐜囪緝寰€骞存潵璇磋繕鏄緝灏戙€傘€?/p>
鍖椾含澶у绗竴鍖婚櫌鍛煎惛鍜屽嵄閲嶇棁鍖诲绉戜富浠荤帇骞垮彂鏁欐巿鍚屾牱琛ㄧず锛屼粖鍐祦鎰熺柅鎯呮儏鍐靛彲鑳藉彈鍒扮柅鎯呯鎺ф帾鏂借皟鏁寸殑褰卞搷銆傘€屼粖鍐嚭鐜版祦鎰熸祦琛岀殑椋庨櫓杩樻槸姣旇緝楂樼殑銆傚啲瀛ｆ湰韬篃鏄祦鎰熼珮鍙戠殑瀛ｈ妭锛岃櫧鐒剁幇鍦ㄥぇ瀹惰繕鎴寸潃鍙ｇ僵锛屼絾浜虹兢鑱氶泦姣旇繃鍘昏鏇撮绻佷簡锛岃繖瀵逛簬鏂板啝銆佹祦鎰熻繖绫讳紶鏌撴€х柧鐥呮潵璇达紝鎻愪緵浜嗗湪浜虹兢涓紶鎾殑鏈夊埄鏉′欢銆傘€?/p>
銆岃繖涓ゅ勾鎴戜滑閲囧彇鐨勫緢澶氭帾鏂藉湪鎺у埗鏂板啝鐤儏鐨勫悓鏃讹紝涔熸妸娴佹劅涓€璧锋帶鍒朵綇浜嗭紝杩欏綋鐒舵槸濂戒簨銆備絾鎴戜滑涔熼渶瑕佺湅鍒帮紝瀵规暣浣撲汉缇よ€岃█锛岀敱浜庢祦鎰熺殑娴佽鍑忓皯锛屼汉缇ゆ暣浣撳娴佹劅鐨勬姉浣撴按骞虫槸鍋忎綆鐨勶紝闅忕潃鎴戜滑绀句細闈㈡椿鍔ㄧ殑鏀惧紑锛屾祦鎰熷彲鑳借秮铏氳€屽叆锛屽紩璧锋祦琛屻€?/strong>銆嶇帇骞垮彂鏁欐巿璇淬€?/p> 鍙岄噸鎰熸煋锛氬彲鑳藉紩璧锋洿涓ラ噸鍚庢灉 鍦ㄤ袱绉嶇梾姣掔殑鍙犲姞娴佽瓒嬪娍涓嬶紝鏄惁浼氬嚭鐜颁竴涓汉鍚屾椂鎰熸煋涓ょ姣掓牚鐨勬儏鍐碉紵鍚堝苟鎰熸煋鍙堜細甯︽潵鎬庢牱鐨勫悗鏋滐紵 涓€椤规潵鑷姹夊ぇ瀛︾梾姣掑鍥藉閲嶇偣瀹為獙瀹ょ殑鐮旂┒璁や负锛?strong>鎰熸煋娴佹劅鐥呮瘨鍙兘浼氭樉钁椾績杩涙柊鍐犵梾姣掔殑鎰熸煋銆?/strong> 鐮旂┒鍥㈤槦棣栧厛鐢ㄦ柊鍐犲亣鐥呮瘨鍜屾椿鐥呮瘨鍒嗗埆涓庢祦鎰熺梾姣掞紙H1N1 鍨嬨€丠3N2 鍨嬨€佷箼鍨嬫祦鎰熺梾姣掞級鍏辨劅鏌撲汉 ACE2 杞熀鍥犲皬榧狅紝鍙戠幇娴佹劅鐨勫崟鐙劅鏌撲細寮曡捣 ACE2 琛ㄨ揪姘村钩杞诲井涓婅皟锛?锝?鍊嶏級锛屼絾娴佹劅涓庢柊鍐犲叡鎰熸煋鍒欎細寮虹儓涓婅皟 ACE2 琛ㄨ揪姘村钩锛堢害 20 鍊嶏級銆傜爺绌惰涓猴紝娴佹劅鐥呮瘨鎰熸煋閫氳繃鍚姩 ACE2 鐨勮〃杈惧苟淇冭繘鍏跺悗鐨勫姞閫熻〃杈捐繃绋嬶紝浠庤€屽姞閲嶆柊鍐犵梾姣掔殑鎰熸煋銆?/p> 鍚屾椂锛岀爺绌惰繕鍙戠幇锛屽湪鏂板啝鐥呮瘨鍙椾綋浜?ACE2 杞熀鍥犲皬榧犱腑锛屾祦鎰熶笌鏂板啝鐥呮瘨鍏辨劅鏌撲細寮曡捣鏇翠弗閲嶇殑鑲洪儴鐥呯悊鎹熶机鍜屾洿楂樼殑鏂板啝鐥呮瘨杞介噺鈥斺€旇繖涔熸剰鍛崇潃鍙兘瀵艰嚧鏇翠负涓ラ噸鐨勭柧鐥呫€俒5] 涓嶈繃锛岀爺绌惰涓猴紝鍏跺畠甯歌鐨勫懠鍚搁亾鐥呮瘨濡傚壇娴佹劅鐥呮瘨銆佸懠鍚搁亾鍚堣優鐥呮瘨銆侀蓟鐥呮瘨绛夋殏涓嶅叿澶囦績杩涙柊鍐犵梾姣掓劅鏌撶殑鑳藉姏銆?/strong> 閭ｄ箞锛岀湡瀹炰笘鐣岀殑鎯呭喌绌剁珶濡備綍锛?/p> 鍦ㄧ柅鎯呮棭鏈燂紝涓€椤规潵鑷姹夌殑鐮旂┒鍥為【鎬у垎鏋愪簡 2020 骞?1 鏈?28 鏃ヨ嚦 2020 骞?3 鏈?24 鏃ュ湪姝︽眽鍚屾祹鍖婚櫌鎺ュ彈娌荤枟鐨?213 鍚嶆柊鍐犳偅鑰呯殑鎯呭喌锛屽叾涓?97 鍚嶆偅鑰咃紙45.5%锛夌殑鎶楃敳鍨嬫祦鎰熺梾姣掑厤鐤悆铔嬬櫧 M 鎶椾綋妫€娴嬪憟闃虫€с€傜爺绌惰繕璁や负锛屽悎骞舵劅鏌撴柊鍐?娴佹劅鐨勬偅鑰呯殑涓村簥鎯呭喌涓庣棁鐘舵ā寮忓拰鍙劅鏌撴柊鍐犵殑鎮ｈ€呯浉浼笺€俒3] 鍙︿竴椤规潵鑷箍宸炵殑鐮旂┒鍒欒涓猴紝鍚堝苟鎰熸煋涓昏褰卞搷骞撮緞杈冨ぇ鐨勪汉缇わ紝骞朵笖涓庤緝宸殑涓村簥缁撴灉鐩稿叧銆?/strong> 鐮旂┒绾冲叆浜嗘潵鑷箍宸炲競绗叓浜烘皯鍖婚櫌鐨?505 鍚嶆偅鑰咃紝鍏朵腑 220 浜轰负 H1N1 娴佹劅鎰熸煋锛?49 浜轰负鏂板啝鎰熸煋锛屽悎骞舵劅鏌撴柊鍐?娴佹劅鐨?36 浜恒€傚湪鏂板啝浣忛櫌鎮ｈ€呬腑锛?H1N1 娴佹劅鍚堝苟鎰熸煋鐨勬瘮渚嬩负 12.6%锛?6/285锛夈€傜粨鏋滃彂鐜帮紝涓庡崟涓€鎰熸煋鐩告瘮锛屽悎骞舵劅鏌撳彂鐢熸€ユ€ц偩鎹熶机銆佹€ユ€у績鍔涜“绔€佺户鍙戞€х粏鑿屾劅鏌撱€佸鍙舵蹈娑﹀拰鍏ヤ綇 ICU 鐨勬鐜囧鍔犮€傚湪鎴愬勾浣忛櫌鎮ｈ€呬腑锛屽悎骞舵劅鏌撴瘮杩欎袱绉嶇梾姣掔殑鍗曚竴鎰熸煋寮曡捣鐨勭柧鐥呮洿涓ラ噸銆俒3]
鍥炬簮锛氬弬鑰冭祫鏂?3
2022 骞?4 鏈堬紝涓€椤规潵鑷嫳鍥界殑鐮旂┒鍒婅浇浜庢煶鍙跺垁銆傜爺绌惰皟鏌ヤ簡 2020 骞?2 鏈?6 鏃ヨ嚦 2021 骞?12 鏈?8 鏃ユ湡闂村湪鑻卞浗浣忛櫌鐨?6965 鍚嶆柊鍐犳偅鑰呮儏鍐碉紝鍏朵腑 583 渚嬶紙8.4%锛夋偅鑰呮娴嬪埌鍛煎惛閬撶梾姣掑悎骞舵劅鏌擄細鍏朵腑 227 渚嬫偅鑰呭悎骞舵劅鏌撴祦鎰熺梾姣掞紝220 渚嬫偅鑰呭悎骞舵劅鏌?RSV锛?36 渚嬫偅鑰呭悎骞舵劅鏌撹吅鐥呮瘨銆?/p>
鐮旂┒杩涗竴姝ュ彂鐜帮紝涓庡崟涓€鐨勬柊鍐犳劅鏌撶浉姣旓紝鍚堝苟鎰熸煋娴佹劅鐥呮瘨涓庢帴鍙楁湁鍒涙満姊伴€氭皵鐨勬鐜囧鍔犳湁鍏炽€傚悓鏃讹紝鏂板啝涓庢祦鎰熺梾姣掑拰鑵虹梾姣掑悎骞舵劅鏌撳潎涓庢浜℃鐜囩殑澧炲姞鏄捐憲鐩稿叧銆?/strong>[4]
鍥炬簮锛氬弬鑰冭祫鏂?4
闇€瑕佹敞鎰忕殑鏄紝涓婅堪鍥為【鎬у垎鏋愮爺绌跺閫夊彇鑷柊鍐犱綇闄㈡偅鑰咃紝鑰岃繖浜涙偅鑰呬竴鑸柧鐥呯▼搴﹁緝涓轰弗閲嶏紝鎴栧睘浜庢柊鍐犳槗鎰熶汉缇わ紝涓嶈兘瀹屽叏浠ｈ〃鏅€氱兢浣撶殑鍚堝苟鎰熸煋姒傜巼鍜岀柧鐥呭彂灞曟儏鍐点€?/p>
銆屽湪鍖椾含鐨勫皯鏁扮梾渚嬩腑锛屾垜浠‘瀹炲凡缁忚瀵熷埌浜嗘柊鍐犲拰娴佹劅鍚屾椂鎰熸煋鐨勬儏鍐点€傘€?/strong>鐜嬪箍鍙戞暀鎺堣銆傘€屽悎骞舵劅鏌撳彲鑳戒細瀵艰嚧鎮ｈ€呯殑鐥呮儏鏇翠弗閲嶏紝閭ｄ箞鍦ㄨ繖绉嶆椂鍊欙紝鍙鎮ｈ€呰繘琛屽崟绾殑鏂板啝娌荤枟鍙兘鏄笉澶熺殑锛屾垜浠殑涓村簥鏁戞不鐨勭瓥鐣ヤ篃瑕佹湁鎵€杞彉锛岄拡瀵瑰叿浣撶殑鎰熸煋鎯呭喌杩涜鏈夋晥鐨勬姉鐥呮瘨娌荤枟锛屾潵闄嶄綆閲嶇棁銆佹浜＄殑鍙戠敓姒傜巼銆傘€?/p> 銆屾劅鏌撲簡鏂板啝鎴栨祦鎰熺梾姣掑悗锛屼汉浣撳厤鐤姏涓嬮檷锛屽湪杩欐鏃堕棿鏈夊彲鑳藉嚭鐜板悎骞舵劅鏌撶殑鎯呭喌銆傘€嶅垬鍙堝畞鏁欐巿璇达紝銆屼絾杩欎釜闂闇€瑕佽京璇佸湴鐪嬪緟锛屼竴鑸潵璇达紝鎰熸煋浜嗘柊鍐犵殑鎮ｈ€呴兘澶勪簬涓ユ牸鐨勯槻鎶ょ姸鎬侊紝鎴栧眳瀹堕殧绂绘瀬灏戞帴瑙﹀浜猴紝鍦ㄨ繖绉嶆儏鍐典笅锛屼竴瀹氱▼搴︿笂涔熻兘棰勯槻娴佹劅銆傘€?/strong> 鍒樺張瀹佹暀鎺堝悓鏃舵寚鍑猴紝瀵逛簬娴佹劅鐨勯闃诧紝渚濈劧瑕佹敞鎰忕柅鑻楃殑鎺ョ锛岃繖瀵逛簬浜虹兢涓€佸勾浜恒€佸効绔ョ瓑鏄撴劅浜虹兢鑳藉鎻愪緵閲嶈淇濇姢銆?/p> 鐜嬪箍鍙戞暀鎺堣〃绀猴紝鏂板啝娴佹劅鐨勫彔鍔犳祦琛屾槸鏈潵鍊煎緱鎸佺画鍏虫敞鐨勫姩鍚戙€?/p> 銆屾暣浣撴潵鐪嬶紝鐩墠瑙傚療鍒板悎骞舵劅鏌撶殑鐥呬緥骞朵笉澶氾紝杩欐槸鍥犱负娴佹劅涔熷彈鍒版柊鍐犻槻鎶ゆ帾鏂界殑褰卞搷锛屽畠鐨勪紶鎾兘鍔涗篃涓嶅強鏂板啝銆傘€嶇帇骞垮彂鏁欐巿璇达紝銆屼絾鏄紝瀹冩湁鍙兘闅愯棌鍦ㄦ柊鍐犵梾浜轰腑锛屽鑷撮噸鐥囩梾渚嬬殑鍑虹幇锛屽洜姝ら渶瑕佹彁楂樿鎯曪紝閫傛椂杩涜鐥呭師瀛︾殑鐩戞祴鍜岃皟鏌ワ紝鐪嬪綋涓嬫祦鎰熺殑鍙戠敓鎯呭喌锛屼互鍙婇殢鐫€鏃堕棿鎺ㄧЩ锛屾祦鎰熺殑瓒嬪娍鏄惁浼氭湁鎵€澧炲姞銆備竴鏃︽湁涓婂崌鐨勮秼鍔匡紝瑕佸強鏃跺彂鍑洪璀︼紝璁╂垜浠殑鍖荤枟鏈烘瀯鑳藉鍙婃椂鍋氬ソ鍑嗗銆?/strong>銆嶏紙绛栧垝锛歾_popeye锝滅洃鍒讹細gyouza锛?/p> 鑷磋阿锛氭湰鏂囩粡聽涓浗鍖昏嵂鏁欒偛瀛︿細鍚嶈獕浼氶暱銆佽憲鍚嶅懠鍚哥梾涓撳 鍒樺張瀹?鏁欐巿銆佸寳浜ぇ瀛︾涓€鍖婚櫌鍛煎惛鍜屽嵄閲嶇棁鍖诲绉戜富浠?鐜嬪箍鍙?鏁欐巿 涓撲笟瀹℃牳 棰樺浘鏉ユ簮锛氫汉姘戣瑙?/p> 鍙傝€冭祫鏂欙細 [1]https://cdn.who.int/media/docs/default-source/influenza/influenza-updates/2022/2022_12_26_surveillance_update_435.pdf?sfvrsn=549d2de_1&download=true [2]https://www.pnas.org/doi/10.1073/pnas.2013182117 [3]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8013771/ [4]https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)00383-X/fulltext
