安徽省滁州市发热伴血小板减少综合征危险因素的病例对照研究

A case-control study on risk factors of severe fever with thrombocytopenia syndrome in Chuzhou City,Anhui Province

目的探讨安徽省滁州市发热伴血小板减少综合征的发病危险因素,为该病的防治工作提供科学依据。方法采用性别、年龄、住址匹配的1∶4配对病例对照研究,对安徽省滁州市的发热伴血小板减少综合征病例和选取的对照人群进行问卷调查,采用单因素和多因素的配对条件Logistic回归分析筛选危险因素。结果单因素分析中有统计学意义的变量为:发病前1月与病例接触、接触身上有蜱虫的狗、被蜱虫叮咬、生活区周围有蜱虫和工作间歇坐卧草地(均有P<0.05)。进一步的多因素分析结果显示:发病前1月与病例接触(OR=5.44,95%CI:1.56~19.04,P=0.004)、接触身上有蜱虫的狗(OR=12.81,95%CI:3.20~51.25,P<0.001)和被蜱虫叮咬(OR=47.25,95%CI:6.94~321.53,P<0.001)是发热伴血小板减少综合征发病的主要危险因素。结论与病例接触史、接触身上有蜱虫的狗和被蜱虫叮咬是发热伴血小板减少综合征的主要发病危险因素,需加强对高发人群健康宣教和个人防护指导。

Objective To explore the risk factors for severe fever with thrombocytopenia syndrome （SFTS） and to provide evidence for the prevention and control of the disease. Methods A 1 ： 4 matched case-control study was conducted among SFTS cases and controls matched by sex, age and address. Standardized questionnaires were used to collect detailed information about their demographics and risk factors for severe fever with thrombocytopenia syndrome virus （SFTSV） infection. Risk factors for SFTS were identified using univariate and multivariable conditional Logistic regression models. Results In the univariate conditional Logistic regression model, the following factors were associated with SFTSV infec- tion ： contacting with SFTS patients, exposure to dogs with ticks, tick bites, living areas surrounded by ticks and sitting on the lawn during break times at work（ all P 〈 0. 05 ）. The results of the multivariable conditional Logistic regression model showed that contacting with SFTS patients （OR = 5.44, 95% CI： 1.56-19. 04, P = 0. 004）, exposure to dogs with ticks （ OR = 12. 81, 95% CI： 3.20-51.25, P 〈0. 001 ） and tick bites （ OR =47. 25, 95% CI：6. 94-321.53, P 〈0. 001 ） were risk factors for SFTSV infection. Conclusions Contacting with SFTS patients, exposure to dogs with ticks, and tick bites were risk factors for SFTSV infection. It is necessary to strengthen health education on personal protective behaviors among the high-risk population.