狂犬病病例暴露后Cox回归生存分析

Cox regression analysis of human rabies cases after exposure

目的分析狂犬病暴露后影响因素,探索病例暴露后生存与风险随时间变化的规律。方法收集安徽省2005～2013年483例狂犬病个案资料,采用Epi Data3.1软件录入数据库,用SPSS对数据进行Cox回归分析。结果狂犬病潜伏期为正偏态分布,中位数潜伏期为70d,Cox比例风险模型分析发现,暴露部位的风险强度：头颈部风险最高,RR=1.73。暴露后接种人用狂犬病疫苗,则生存情况越好,RR=0.65。结论狂犬病暴露后,应及时规范处置暴露者的咬伤部位,特别是暴露于头颈部的患者,并及时免疫接种。

Objective To investigate human rabies cases and explore the influence factors and survival- hazard tendency of human rabies after exposure,and to provide evidences for control and prevention of rabies in Anhui province. Methods Data from 483 questionnaires for human rabies cases occurred during 2005- 2013 in Anhui province were put into Epidata 3. 1 to build a data- base. SPSS were used for Cox regression analysis. Results Incubation period of rabies was positively skew distribution,and the median was seventy- day. Cox model analysis showed that the wound treatment and inoculation after exposure were the real factors influencing latent period. The risk of cases with wound on head or face was the highest（ RR = 1. 73）. The incubation period of cases with inoculation after exposure was longer significantly than that of no inoculation after exposure（ RR = 0. 65）. Conclusion Exposed to rabies,the bit sites should be timely regulate disposed and immunized,particularly the head and neck wound.