狂犬病Ⅲ级暴露者被动免疫制剂使用影响因素分析

Influential factors of immune globulin use among persons with grade Ⅲ rabies virus exposure

目的分析陕西省铜川市狂犬病Ⅲ级暴露人群使用被动免疫制剂的影响因素。方法选取2014年9月1日—2015年8月31日陕西省铜川市犬伤门诊狂犬病Ⅲ级暴露者共451人进行调查,采用SPSS 13.0软件进行描述性统计分析和单因素、多因素非条件logistic回归分析。结果铜川市犬伤门诊狂犬病Ⅲ级暴露者被动免疫制剂接种率为30.8%(139/451),年龄>15岁(OR=1.278,95%CI=1.038~1.572)、在农村居住(OR=2.438,95%CI=1.478~4.021)、多部位暴露(OR=2.486,95%CI=1.135~5.447)、被流浪犬猫致伤(OR=2.153,95%CI=1.187~3.906)、人均月收入>1 000元(OR=2.588,95%CI=1.915~3.499)、处置费用由犬主或保险支付者(OR=4.313,95%CI=2.076~8.958)是铜川市狂犬病Ⅲ级暴露者狂犬病被动免疫制剂接种率高者。结论铜川市犬伤门诊狂犬病Ⅲ级暴露者被动免疫制剂接种率低,年龄、居住地、多部位暴露、致伤动物来源、人均月收入及处置费用支付者是影响被动免疫制剂使用的主要因素。

Objective To analyze influential factors of immune globulin use among persons with grade Ⅲ rabies virus exposure in Tongchuan city of Shaanxi province.Methods A questionnaire survey was conducted among 451 visitors of dog injury clinics with grade Ⅲ rabies virus exposure in Tongchuan city between September 1st,2014 and August 31st,2015. Descriptive study,univariate analysis,and unconditional logistic regression analysis were performed using SPSS 13.0.Results The acceptance rate of immune globulin among the grade Ⅲ rabies virus exposed persons was 30.8%.Multivariate logistic regression analysis showed the exposed persons with following conditions were more likely to use immune globulin：aged 〉15 years （odds ratio [OR]=1.278,95% confidence interval [95%CI]：1.038-1.572）,living in rural area （OR=2.438,95%CI：1.478-402.1）,with multiple injuries （OR=2.486,95%CI：1.135-5.447）,injured by street dogs or cats （OR=2.153,95%CI：1.187-3.906）,with an average personal monthly income of more than 1 000 yuan RMB （OR=2.588,95%CI：1.915-3.499）,and paying the medication cost by others such as an owners of a dog involved or an insurance payer （OR=4.313,95%CI=2.076-8.958）.Conclusion The acceptance rate of immune globulin is low among the persons with grade Ⅲ rabies virus exposure in Tongchuan city and the rate is mainly influenced by the age,residential area,severity of the injury,and average monthly income of the exposed person and the payer of the medication cost.