山东省肾综合征出血热死亡病例分析  

Analysis on death case of hemorrhagic fever with renal syndrome in Shandong province

作　　者：李健[1] 王志强[2] 胡茂红[1] 赵仲堂[1] 

机构地区：[1]山东大学公共卫生学院流行病与卫生统计学研究所,济南250012 [2]山东省疾病预防控制中心

出　　处：《中国公共卫生》2007年第4期490-491,共2页Chinese Journal of Public Health

基　　金：山东省医药卫生重大创新研究计划(CX02207)

摘　　要：目的探讨山东省2004~2005年肾综合征出血热（Hemorrhagic Fever with Renal Syndrome,HFRS）病例的死亡原因,以便采取相应对策。方法按中国疾病预防控制中心《全国流行性出血热监测方案》中的个案调查表对山东省2004~2005年全部HFRS死亡病例进行调查,并进行统计学分析。结果山东省2004,2005年HFRS病死率分别比前一年上升95.45%和2.32%,死亡病例平均年龄为51.15岁,农民占77.78%,男女性别比例2.6∶1。对41例进行了特异性抗体检测,阳性率为75.61%。大部分病例临床症状不典型,从发病到就诊时间间隔平均为3.93 d,死亡前有鼠类接触史。结论山东省2004,2005年HFRS病死率有上升趋势;病例症状不典型、就诊时间晚、诊疗水平低和经济状况是造成病死率较高的重要原因;HFRS病死率升高可能是由于姬鼠型病例增多和病毒变异、毒力增加引起。Objective To discuss the death causes of hemorrhagic fever with renal syndrome（HFRS） cases in Shandong province from 2004 to 2005 and make effective measures to reduce the death cases of HFRS. Methods Data on the HFRS death cases in Shandong province from 2004 to 2005 was collected according to the National Epidemic Hemorrhagic Fever Monitoring Project published by Chinese Center for Disease Control and Prevention. Database was set up and analyzed statistically. Results The fatality rates raised 95.45 % and 2.32 % in 2004 and 2005 compared with the year before in Shandong province. Death cases mainly occurred in November. With the average age of 51.15, the death cases were mainly peasants containing 77.78 %. Male death cases were obviously more than those of female with the ratio 2.6 to 1.41. Serum specimens wei＂e detected and the positive rate was 75.61%. Most cases had atypical clinical symptoms. The average time was 3.93 days from falling ill to seeing doctor. Most of the cases touched mice before death. Conclusion The fatality rates have the potential to rise in Shandong province in the years of 2004 and 2005. Atypical symptoms, delaying to see doctor, low level in diagnosing and treating and poor economy conditions are the main death causes of HFRS. The rising ratio of Hataan typus cases, virus variation and virulence increase may be the important reasons of the increase of fatality rates.

关 键 词：肾综合征出血热 死亡原因 鼠类 

分 类 号：R373.32[医药卫生—病原生物学]