狂犬病人免疫球蛋白使用影响因素分析

Analysis on influencing factors of human rabies immunoglobulin usage

目的了解福州城区狂犬病Ⅲ级暴露者狂犬病人免疫球蛋白(HRIG)使用的影响因素,为开展狂犬病预防处置工作提供依据。方法逐一统计2018年7月1日至2019年6月30日福州某疾控中心门诊部初次免疫接种的1 753例狂犬病Ⅲ级暴露者预防处置病历记录并汇总,采用SPSS 17.0软件进行单因素统计分析。结果在1 753例初次接种狂犬疫苗的狂犬病Ⅲ级暴露者中,注射HRIG者464例,HRIG注射率仅为26.47%。0~岁组、0~kg组、儿童、暴露部位>3个、暴露伤及肌肉层、他家养的动物、家庭人均10 000元以上收入者、费用由保险支付组的HRIG注射率最高,分别为48.09%、78.26%、41.91%、51.19%、29.22%、45.60%、94.12%、65.71%,不同年龄、体重、职业、暴露部位数量与程度、致伤动物来源、家庭人均月收入、费用支付者和有无致伤动物免疫史因素影响HRIG的使用差异均有统计学意义(P<0.01)。结论对于狂犬病Ⅲ级暴露者,特别是大人、低收入群体(农民、工人),未购买保险者要建议其注射HRIG,以降低狂犬病的发病率。

Objective To understand the influence factors of the classⅢexposers’HRIG usage in Fuzhou city,so as to provide the evidence for the further work of the prevention and treatment of rabies.Methods To make one-by-one statistic analysis for the record of prevention and treatment of 1753 cases of firstly vaccinated exposers of rabies classⅢin the outpatient department of a certain CDC in Fuzhou during July 1 st,2018-June 30 th,2019.Single-factor statistical analysis with SPSS 17.0 was employed.Results Among the 1753 cases of firstly vaccinated exposers of rabies classⅢ,464 ones were vaccinated with HRIG,and the rate of HRIG was only 26.47%.It has demonstrated that HRIG vaccination rate ranks highest among the followings:age group of 0-,weight group of 0-kg,children,exposed body with more than 3 parts,exposed injury and muscular layer,wildly-untamed animals,people with a per capita income of more than 10000 yuan,and group of payment by insurance,all of which respectively ranks as:48.09%,78.26%,41.91%,51.19%,29.22%,45.60%,94.12%and 65.71%.All the following factors influencing the HRIG usage have been proved to be statistically significant(P<0.01):different ages,weight,vocations,numbers and degrees of exposed parts,sources of causing injuries by animals,monthly income per capita,fee payers,and whether there was immunity record about the causing injuries by animals.Conclusion For those exposers of rabies classⅢ,especially adults and low-income groups(farmers and workers),and those who have not purchased insurance,the inoculation of HRIG is recommended so as to reduce the incidence rate of rabies.