2012—2018年天津市某院狂犬病流行病学分析  

An epidemiological analysis of rabies in a hospital of Tianjin from 2012 to 2018

作　　者：苗静[1] 郭丽颖[1] 李秋伟[1] 王丽[1] 王静[1] 任玮[1] 徐懂 赵立聪 贾建伟[1] MIAO Jing;GUO Li-ying;LI Qiu-wei;WANG Li;WANG Jing;REN Wei;XU Dong;ZHAO Li-cong;JIA Jian-wei(First Department of Integrated Traditional Chinese and Western Medicine,Tianjin Second People’s Hospital,300192,China)

机构地区：[1]天津市第二人民医院中西医结合一科,300192 [2]天津中医药大学研究生院,301617

出　　处：《传染病信息》2020年第6期549-552,共4页Infectious Disease Information

基　　金：国家中医药防治传染病重点研究室建设项目(201034)。

摘　　要：目的了解狂犬病的流行病学及临床特点,探讨狂犬病的防治策略。方法回顾性收集并分析2012-2018年天津市某院35例狂犬病患者一般资料、暴露情况、临床症状、血常规、生化指标数据。结果35例患者中,男性多于女性,年龄>40岁人群高发,15岁以下儿童占5.71%;35例狂犬病患者中,农村患者占65.71%,城市患者占34.29%。此外,伤口位于手部、3级暴露及未进行规范性的伤口处理、未行狂犬病疫苗或免疫球蛋白注射是狂犬病发病的常见因素。23例患者在感染后6个月内发病,从确诊到死亡中位生存期为3 d。患者以恐水怕风、烦躁兴奋为主要临床表现;辅助检查以WBC、中性粒细胞明显升高为主,AST、CK、CK-MB可出现升高,部分可以出现轻微的肾损害。结论狂犬病仍以散发为主,呈季节性发病,犬是主要的传染源,农村人群和>40岁人群是防治重点对象。应加强对农村狂犬病预防知识的宣传,提高动物狂犬病疫苗接种覆盖率,保证人用狂犬病疫苗接种率,推动自主产权的狂犬病治疗药物的研发可能是狂犬病未来防治的重要策略。Objective To understand the epidemiology and clinical characteristics of rabies and to explore the strategy of prevention and treatment of rabies.Methods The general data,exposure,clinical symptoms,blood routine test results and biochemical indicator date of 35 cases of rabies in a hospital of Tianjin from 2012 to 2018 were retrospectively collected and analyzed.Results Among the 35 patients,men were more than women.A higher incidence rate of rabies was observed at the age of over 40 years old,while children under 15 years old accounted for 5.71%.Among 35 rabies patients,65.71%cases were from rural areas and 34.29%from cities.In addition,the wound located in the hands,Grade-3 exposure.No standardized wound treatment,and no injections of rabies vaccine or immunoglobulin were common pathogenic factors of rabies.The disease usually occurred in 23 patients within 6 months after infection,the median survival from the diagnosis to death was 3 days.The clinical manifestations of patients were mainly the fear of water,fear of wind,irritability and excitement.Auxiliary examination mainly showed that blood WBC and neutrophils were significantly increased,while AST,CK,CK-MB could be increased.Some cases may have mild renal damage.Conclusions Rabies is a sporadic and seasonal disease.Dogs are the main source of infection.Rural population and people over 40 years old are the key population for prevention and control.It’s suggested to strengthen the propaganda of rabies prevention knowledge in rural areas,improve the coverage rate of animal rabies vaccine,ensure the coverage rate of rabies vaccine for human use,and promote the research and development of rabies treatment drugs with independent property rights,which may be important strategies for rabies prevention and control in the future.

关 键 词：狂犬病 流行病学 特征 防治策略 

分 类 号：R512.99[医药卫生—内科学] R181.3[医药卫生—临床医学]