2016年南京市小龙虾相关横纹肌溶解综合征流行病学特征：一项多中心回顾性调查  

Epidemiology characteristics of crawfish related rhabdomyolysis in Nanjing, 2016： a multicenter retrospective investigation

作　　者：马绍磊 徐昌盛[1] 刘松桥[1] 胡宗风[1] 刘文革[1] 张劲松[2] 陈旭峰[2] 聂时南 张均 沙杜鹃 李津金[5] 倪海滨[6] 秦海东 高莹[8] 王巍 吴成放 余湛 朱从健 Ma Shaolei Xu Changsheng Liu Songqiao Hu Zongfeng Liu Wen＇ge Zhang Jinsong Chen Xufeng Nie Shinan Zhang Jun Sha Dujuan Li Jinjin Ni Haibin Qin Haidong Gao Ying Wang Wei Wu Chengfang Yu Zhan Zhu Congjian(Department of Emergency, Zhongda Hospital, Southeast University, Nanjing 210009, Jiangsu, China Department of Emergency, Jiangsu Provincial People＇ s Hospital, Najing 210029 Jiangsu, China Department of Emergency, Nanfing General Hospital, Nanfing 210002, Jiangsu, Chin Department of Emergency, Nanfing Drum Tower Hospital, Nanfing 210008, Jiangsu, Chin Department of Emergency, Jiangsu Provincial Traditional Chinese Medicine Hospital, Nanjing 210004, Jiangsu, Chin Department of Emergency, Jiangsu Provincial Hospital on Integration of Chinese and Western Medicine, Nanjing 210028, Jiangsu, Chin Department of Emergency, the First Hospital of Nanjing, Nanjing 210006, Jiangsu, Chin Department of Emergency, the Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, Jiangsu, Chin Department of Critical Care Medicine, Pukou Hospital of Nanjing, Nanjing 210031, Jiangsu, Chin Department of Emergency, Jiangbei People＇ s Hospital, Nanjing 210048, Jiangsu, China Department of Emergency, Nanjing Jiangning Hospital, Nanjing 211100, Jiangsu, China epartment of Emergency, Nanjing Tongren Hospital, Nanjing 211102, Jiangsu, Chin)

机构地区：[1]东南大学附属中大医院急诊科,江苏南京210009 [2]江苏省人民医院急诊科,江苏南京210029 [3]南京总医院急诊科,江苏南京210002 [4]南京鼓楼医院急诊科,江苏南京210008 [5]江苏省中医院急诊科,江苏南京210004 [6]江苏省中西医结合医院急诊科,江苏南京210028 [7]南京市第一医院急诊科,江苏南京210006 [8]南京医科大学第二附属医院急诊科,江苏南京210011 [9]南京市浦口医院重症医学科,江苏南京210031 [10]南京江北人民医院急诊科,江苏南京210048 [11]南京市江宁医院急诊科,江苏南京211100 [12]南京同仁医院急诊科,江苏南京211102

出　　处：《中华危重病急救医学》2017年第9期805-809,共5页Chinese Critical Care Medicine

基　　金：江苏省医药卫生面上科研项目（H201432）

摘　　要：目的 分析2016年南京市小龙虾相关横纹肌溶解综合征（RM）的流行病学特征.方法 回顾性查询2016年1至12月南京市21家医院的门急诊和住院电子病案系统,检索出诊断中包括RM的所有患者;排除非小龙虾相关RM患者.描述纳入患者的流行病学特征;通过地理信息系统（GIS）对空间数据进行采集、管理和分析,并使其可视化;分析疾病的空间分布特征;探索疾病病因,并进行预测.应用GeoDa 1.8软件对数据进行全局和局部空间自相关分析.结果 共收集小龙虾相关RM患者1183例,排除外伤、剧烈运动、热射病、肌炎、中毒、药物、遗传性疾病导致的RM病例59例,最终1124例患者纳入分析.性别分布：男性占36.48%（410/1124）,发病率为12.54/10万;女性占63.52%（714/1124）,发病率为21.86/10万.年龄分布：发病年龄为34（28,43）岁.时间分布：7至8月为小龙虾相关RM发病高峰,发病例数占总发病例数的96.53%.区域分布：发病率居前4位的城区分别为毗邻长江的浦口区（41.54/10万）、建邺区（25.94/10万）、栖霞区（25.73/10万）、鼓楼区（25.04/10万）.全局空间自相关分析显示,Moran I指数=0.427,Z=2.646,P=0.003,提示小龙虾相关RM呈正向空间自相关,说明2016年南京市小龙虾相关RM在整体上呈现空间聚集型分布.局部空间自相关分析显示,2016年南京市行政区间小龙虾相关RM的发病率呈现长江下游南京段流经区域及周边地区高于南京市整体发病率均值的高-高聚集形式,主要为浦口区、建邺区和六合区.结论 2016年南京市小龙虾相关RM发病率有明显的区域集中分布特征和整体上的空间聚集性,高发病率地区主要集中在长江下游南京段流经区域.Objective To investigate the epidemiology characteristics of crawfish related rhabdomyolysis （RM） in Nanjing, 2016.Methods Outpatient and inpatient electronic medical system of 21 hospitals in Nanjing during 2016 were retrospectively searched, and all the patients diagnosed with RM were selected. The patients with none crayfish-related RM was excluded. The epidemiology characteristics were depicted. The geographic information system （GIS） was used to collect, manage and analyze the spatial data, to visualize it, to analyze the spatial distribution features of the disease, and to explore the cause of disease prediction. GeoDa 1.8 software was used to analyze the global and local spatial auto-correlation.Results A total of 1183 patients with crawfish related RM were initially screened, excluding 59 patients with RM caused by trauma, severe exercise, heat stroke, myositis, poisoning, drugs, and genetic diseases, and 1124 patients were enrolled. The proportion of men was 36.48% （410/1124） with an incidence of 12.54/100 thousands; while of women was 63.52% （714/1124） with an incidence of 21.86/100 thousands. The median age at onset was 34 （28, 43） years. From July to August, the incidence of crawfish related RM was the highest, accounting for 96.53% of the total number of cases. The top four incidence areas were Pukou （41.54/100 thousands）, Jianye （25.94/100 thousands）, Qixia （25.73/100 thousands）, Gulou （25.04/100 thousands）, all of which were adjacent to the Yangtze River. Global spatial autocorrelation analysis showed： MoranI = 0.427,Z = 2.646,P = 0.003, suggesting that the crawfish related RM had positive spatial autocorrelation. The results showed that the spatial structure of crawfish related RM existed in Nanjing in 2016. Local spatial autocorrelation analysis showed that the ＂high-high＂ concentration areas were Pukou, Jianye and Liuhe. The incidences of above three areas which were the Nanjing section of the lower reaches of the Yangtze River flowed through the region

关 键 词：小龙虾 横纹肌溶解综合征 流行病学 空间分析 可视化 预测 

分 类 号：R685.5[医药卫生—骨科学]