济南市传染病医院1997～2006年肾综合征出血热2164例分析

Analysis on 2164 cases with hemorrhagic fever with renal syndrome hospitalized in Jinan infectious disease hospital from 1997 to 2006

目的探索近年来城市中心传染病医院肾综合征出血热(HFRS)病例特点,为进一步制定防治策略和采取有效措施提供依据。方法收集济南市传染病医院1997～2006年10年间住院确诊HFRS患者的流行病学资料和近5年(2002～2006)住院HFRS患者的临床资料,建立数据库,应用SPSS13.0软件进行统计分析。结果2164例HFRS患者,年龄为1～82岁,平均37.97岁,20～49岁占70.19%,男女比例3:1,农村患者占78.51%,多数患者生活或工作环境中有鼠类活动;发病率逐年下降,未愈/病死率似有下降趋势;发病形式以全年散发为主,春季稍多。临床特点是不典型病例较多,重危患者较多,并发症和继发症复杂。多器官功能衰竭、急性呼吸窘迫综合征、急性肾功能衰竭、颅内出血、DIC是主要死因。结论HFRS仍然是危害人们健康的重要疾病,必须持续灭鼠、杀螨、防护重点人群,积极开展新的实验室诊断方法的研究,提高基层医疗机构诊断水平,加强城市中心传染病医院治疗研究。

Objective To explore characteristics of patients with hemorrhagic fever with renal syndrome(HFRS) hospitalized in urban central infectious disease hospital and provide information for control strategy and implementation of effective measures.Methods Records of HFRS cases hospitalized in Jinan infectious diseases hospital were reviewed.Epidemiology information was collected from those hospitalized in the past decade(1997-2006) and clinical information from those hospitalized in the past 5 years(2002-2006).Database was established and analyzed with software SPSS 13.0.Results Ages of the 2164 cases ranged between 1-82 years with an average of 37.97.Cases aged 20-49 years old took up 70.19%,the male to female ratio was 3∶1 and 78.51% cases occurred in villages.Most patients lived or worked in places where mice visited constantly.The incidence falls year by year,case fatality seems decreased annually.The morbidity was diverging in a year round with slight increase in spring.There were more atypical cases and severe cases with complicated complications.Fatal causes included multiple organ failure,acute respiratory distress syndrome,acute renal failure,intracranial hemorrhage and disseminated intravascular coagulation(DIC).Conclusions HFRS remained a serious public health problem.It has been advised that deratization,mites killing and relevant population protection should be continued,new laboratory diagnostic assay must be under study,diagnostic skills be enhanced in primary health care system,and treatment has to be managed well in urban central infectious disease hospitals.