北京市平谷区农村社区医院恙虫病筛查结果分析  

ANALYSIS OF SCRUB TYPHUS SCREENING RESULTS FROM COMMUNITY HOSPITALS

作　　者：张立芹[1] 田丽丽[2] 林晖[2] 梁慧杰 薛慧[1] 刘志强[1] ZHANG Li-Qin;TIAN Li-Li;LIN-Hui;LIANG Hui-Jie;XUE Hui;LIU Zhi-Qiang(Pinggu District Center for Diseases Prevention and Control, Beijing 101200, China;Institute for Infectious Disease and Endemic Disease Control, Beijing Municipal Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Beijing 100013, China)

机构地区：[1]北京市平谷区疾病预防控制中心,北京101200 [2]北京市疾病预防控制中心,北京市预防医学研究中心传染病地方病控制所,北京100013

出　　处：《寄生虫与医学昆虫学报》2018年第4期200-205,共6页Acta Parasitologica et Medica Entomologica Sinica

基　　金：北京市自然科学基金(7133234)

摘　　要：在恙虫病疫区农村社区医院开展恙虫病早期感染病例筛查研究,选择北京市平谷区发病率较高的王辛庄镇、峪口镇、黄松峪乡、金海湖镇的乡镇卫生院作为筛查医院(筛查组),选择法定传染病疫情报告网(中国疾病预防控制信息系统)疫情上报医院平谷区医院和中医院作为对照组医院,比较同一地区社区筛查和临床诊断恙虫病病例特征的差异,为临床诊疗提供依据。在筛查组和对照组医院选择有流行病学史,具有发热、淋巴结肿大或皮疹的患者作为研究对象,采集患者的血液标本,采用ELISA和PCR法开展检测。2016年平谷区通过疫情网(对照组)报告恙虫病病例156例,同年9—11月份通过社区筛查发现恙虫病实验室检测阳性病例58例,社区监测病例总体阳性检出率为49.57%,其中9—11月病例阳性检出率分别为38.46%、65.22%和42.11%。两种发现途径的病例性别构成无统计学差异,社区筛查病例中农民构成比高于疫情网报病例(χ~2=11.042,P=0.026),监测病例诊断时间早于疫情网报病例。恙虫病早期感染病例临床症状不典型,应在接诊医生和高危人群中开展宣教,密切关注疾病进展,有助于早期诊疗。A cohort scrub typhus screening study was carried out by rural community hospitals within epidemic areas. Rural community hospitals of Wangxinzhuang town, Yukou town, Huangsongyu town and Jinhai lake town were selected for the higher incidence of scrub typhus. Pinggu District Hospital and Pinggu Traditional Chinese Medicine Hospital were selected as clinical diagnosis hospitals. The epidemiological characteristics of community screening cases and clinical diagnosis cases were compared to provide a basis data for clinical diagnosis and treatment. The cases with fever, lymphadenectasis or rash were enrolled as objects of the study. Blood samples were collected and detected by both ELISA and PCR measures. Total of 156 scrub typhus cases were diagnosed in control group and 58 cases were reported by community screening. The positive rate of community screening was 49. 57%. The positive rate of cases appeared in September, October and November were 38. 46%, 65. 22%, 42. 11%, respectively. There was no statistical difference between the genders and between the screening and clinically diagnosed cases. The constituent ratio of farmers in community screening cases was higher than that of clinical diagnosed cases. The diagnosis time of screening cases were earlier than that of clinically diagnosed cases. The characteristics of early infection of scrub typhus are not typical, healthy education is important and helpful in the clinician and high risk population.

关 键 词：恙虫病 筛查 流行病学特征 

分 类 号：R513.2[医药卫生—内科学]