西安市肾综合征出血热的危险因素研究

Study on the risk factors of hemorrhagic fever with renal syndrome in Xi’an City

目的探讨西安市肾综合征出血热(hemorrhagic fever with renal syndrome,HFRS)发生的危险因素,为制定可行的干预措施提供依据。方法从西安市3个HFRS高发区县随机抽取于2011年10月1日～12月31日发病的确诊病例,按1∶2配对的病例对照研究方法进行回顾性调查。数据采用SPSS 13.0软件进行条件Logistic回归分析。结果共收集60份HFRS患者及120份对照问卷。多因素Logistic回归模型中,危险因素按照贡献值大小由高到低依次为发病前1个月内工作场所为建筑工地(OR=17.480,95%CI:3.411～89.586)、发病前1个月内在鼠洞附近坐卧(OR=10.668,95%CI:1.323～85.996)、是边村户(OR=5.047,95%CI:1.673～15.223)、发病前1个月内工作环境周围有河流或池塘(OR=2.772,95%CI:1.057～7.265),而有出血热疫苗接种史(OR=0.179,95%CI:0.058～0.551)和既往患出血热(OR=0.046,95%CI:0.003～0.653)为HFRS的保护因素。结论应加强防鼠灭鼠工作、加大HFRS的宣传力度、制订适合西安地区的疫苗接种策略,以形成有效的人群免疫屏障。

Objective To explore the risk factors of hemorrhagic fever with renal syndrome（HFRS） in Xi＇ an Cit- y, and to provide scientific evidences for intervention strategies. Methods The patients who got ill from October 2011 to December 2011 were sampled randomly from three districts and counties with the highest incidence of HFRS in Xi＇ an City. A 1 ： 2 matched case-control study was adopted to investigate the risk factors. Conditional Logistic regression method was performed to analyze the risk factors by using SPSS 13.0 software. Results Sixty matched pairs were investigated. The re- suits of Logistic regression showed that the risk factors of HFRS by turns were the workplace of building site （ OR = 17. 480, 95% CI：3.411-89. 586） , sitting nearby the rat hole （OR = 10. 668, 95% CI： 1. 323-85. 996）, living in the edge of vil- lage （OR =5.047, 95% CI： 1. 673-15. 223）, and the river or pond around the workplace （OR---2. 772, 95% CI：I. 057- 7.265）. Vaccination （OR =0. 179, 95% CI： O. 058-0. 551 ） and having been exposed to HFRS （OR =0.046, 95% CI： O. 003-0. 653） were the protective factors. Conclusions We should continue to take actions to establish an effective im- mune barrier of the crowd such as extinguishing rats, strengthening to propagandize scientific knowledge, and figuring out the strategy of vaccine inoculation for the area.