铜陵市2016—2017年小龙虾相关横纹肌溶解综合征流行病学调查  

Epidemiological investigation of crayfish related rhabdomyolysis in Tongling, 2016-2017

作　　者：刘聚矩[1] 黄永[1] 邱申伟[1] 何益新[1] 韦宁凯[1] LIU Juju;HUANG Yong;QIU Shenwei;HE Yinxin;WEI Ningkai(Tongling Center for Disease Control and Prevention,Tongling,Anhui 244000,China)

机构地区：[1]铜陵市疾病预防控制中心,安徽铜陵244000

出　　处：《中国热带医学》2018年第9期899-902,949,共5页China Tropical Medicine

摘　　要：目的分析小龙虾相关横纹肌溶解综合征病例的流行病学特征,为进一步探索该病的病因提供借鉴。方法对铜陵市2016—2017年报告的81例横纹肌溶解综合征病例开展流行病学调查,分析病例临床表现、流行病学特征及小龙虾的进食特征等。结果 81例病例发病前24 h内均有进食小龙虾史,中位潜伏期为7 h(范围为2~22 h),临床症状主要表现为肌肉酸痛、肌无力等。肌酸激酶(CK)最高值中位数为3 229 U/L(范围57~79 000 U/L)。2017年报告病例12例少于2016年(69例),病例发病集中于每年的7—8月,2017年女性病例比例高于2016年(P=0.023)。68.4%进食小龙虾的场所为家中,31.6%饭店就餐。50.6%的小龙虾来源为农贸市场,40.5%为自行捕捞。进食小龙虾数量与病例潜伏期(rs=-0.020,P=0.867)和CK最高值(rs=0.161,P=0.208)之间的相关性差异均无统计学意义。结论铜陵市报告的横纹肌溶解综合征病例发病与食用小龙虾有关,应进一步通过病例的发病特征探讨小龙虾导致横纹肌溶解综合征的致病因素,为预防和控制该病提出针对性措施。Objective To investigate the epidemiological characteristics of the cases of crayfish related rhabdomyolysis,so as to provide the reference for further exploration of the pathogeny of the disease. Methods An epidemiologicalinvestigation was carried out among 81 cases of rhabdomyolysis reported in Tongling City, 2016-2017. The clinicalmanifestations, epidemiological characteristics and the feature of crayfish-eating were investigated. Results A total of 81 cases were reported and all the cases had the exposure of eating crayfish in 24 hours before the onset of illness. The averageincubation period was 7 hours（ranging from 2 hours to 22 hours）. The main clinical symptoms were muscle aches andmyasthenia. The median of the highest value of CK was 3 229 U/L（ranging from 57 to 79 000 U/L）. Totally 69 cases werereported in 2016 which were more than that in 2017（12 cases）. The onset of illness of the cases was concentrated in July andAugust. The proportion of women in 2017 was higher than that in 2016（P=0.023）. Totally 68.4% of the cases ate crayfish athome and 31.6% in the restaurants. Totally 50.6% of the crayfish was from the farmer’s markets, and 40.5% was from self-fishing. There were no significant correlations between the number of eating crayfish and the incubation period（rs=-0.020, P=0.867） and the highest value of CK（rs=0.161, P=0.208）. Conclusions The incidence of rhabdomyolysis reported in TonglingCity is related to the consumption of crayfish. Further exploration of the pathogenic factors for rhabdomyolysis caused bycrayfish should be conducted, in order to provide the targeted measures for prevention and control of the disease.

关 键 词：小龙虾 横纹肌溶解综合征 流行病学 哈夫病 

分 类 号：R685.5[医药卫生—骨科学]