湖北省横纹肌溶解综合征病例回顾性调查

Prevalence of rhabdomyolysis syndrome in Hubei province:a retrospective survey

目的了解湖北省近年来横纹肌溶解综合征病例的临床及流行病学特征,为横纹肌溶解综合征预防提供依据。方法采用回顾性调查方法,对2013年1月-2017年4月湖北省9家三甲医院收治的横纹肌溶解综合征病例进行回顾性调查。结果9家医院共诊断横纹肌溶解综合征病例367例,其中2016年发生220例,与食用小龙虾相关者102例。这些病例中,与食用小龙虾相关的病例主要出现在2014和2016年,其余年度以剧烈运动、动物咬伤等多种病因为主。食用小龙虾相关病例的临床特征以肌痛和乏力为主,多数病程为10 d左右,预后较好;病例主要在长江沿岸分布,且有明显的季节性,以中青年和女性为主。2016年湖北省食源性疾病监测系统共报告41例病例,占9家医院2016年诊断食源性病例数的40%(41/102)。结论湖北省实际发生的食源性病例数远超过食源性疾病监测系统的报告病例数,应加强对医疗机构的督导和培训,提高监测系统报告的敏感性,横纹肌溶解综合征病例沿长江沿岸分布,呈一定的规律性。

Objective To investigate clinical and epidemiological characteristics of patients with rhabdomyolysis syndrome(RM)in Hubei province in recent years for providing evidences for the prevention of the disease.Methods We carried out a retrospective survey on RM cases in 9 grade A third-class hospitals in Hubei province from January 2013 to April 2017.Results Totally 367 RM cases were diagnosed in the hospitals during the period,of which 220 were diagnosed in 2016 and 102 were related to the history of crayfish-eating.Among the cases diagnosed,the cases with the history of crayfish-eating mainly occurred in 2014 and 2016,and the cases diagnosed in other years were mainly with histories of strenuous exercise and animal bites.The clinical symptoms of the cases with the history of crayfish-eating were mainly myalgia and fatigue and most of the cases had a course of around 10 days and had a good prognosis.The diagnosed cases were mainly young and middle aged females and the incidents distributed mainly along the Yangtze river and showed an obvious seasonal variation.A total of 41 cases were reported by Hubei Province Foodborne Disease Surveillance System in 2016,accounting for only 40%(41/102)of all foodborne cases diagnosed in the 9 hospitals in 2016.Conclusion The rhabdomyolysis syndrome incidents in Hubei province distribute along the Yangtze river and are of some epidemic features.The actual number of foodborne RM cases in Hubei province is greatly higher than that registered in the foodborne disease surveillance system,suggesting that the sensitivity of the surveillance system needs to be improved.