发热伴血小板减少综合征确诊病例特征及家庭负担调查分析  

Analyzing the characteristics and family burden of severe fever with thrombocytopenia syndrome in confirmed cases

作　　者：刘旭祥[1] 张磊[1] 赵科伕[1] 尤恩情[1] 王文靖 张强 刘溦 LIU Xu-xiang;ZHANG Lei;ZHAO Ke-fu;YOU En-qing;WANG Wen-jing;ZHANG Qiang;LIU Wei Hefei(Center for Disease Control and Prevention,Anhui 230000,China)

机构地区：[1]合肥市疾病预防控制中心,安徽230000

出　　处：《现代预防医学》2021年第19期3574-3578,共5页Modern Preventive Medicine

基　　金：合肥市科技局揭榜挂帅项目(J2020J10)。

摘　　要：目的了解合肥市发热伴血小板减少综合征(SFTS)实验室确诊病例相关特征和家庭负担,为科学、有效防控提供依据。方法回顾性分析SFTS确诊病例流行病学调查表和家庭负担调查表。结果 2014—2019年间合肥市133例SFTS确诊病例,实验室检测阳性率43.75%,死亡22例,SFTS病死率16.5%。合肥市有4个县(市)多发,但病死率无统计学意义(X^(2)=1.230,P=0.312)。75.2%的病例集中在4-7月份。死亡与存活病例平均发病年龄的差异无统计学意义(Z=-1.337,P=0.183),主要是农民(78.2%)。80.5%的病例发病前一个月居住在丘陵/山区,78.9%的病例发病前2周有户外活动,15.8%病例有明确的蜱虫叮咬史。存活与死亡病例发病前家里有无老鼠有统计学意义(X^(2)=7.037,P=0.030)。99.2%的病例首发症状是发热,多数病例有乏力(81.2%)畏寒(61.7%)和食欲减退(55.6%)等非特异性症状,存活和死亡病例是否呕血有统计学差异(X^(2)=5.992,P=0.014)。从发病到确诊治疗M为5天,平均就医2.29次。市级及以上医院诊断率为86.3%。聚集性疫情的传播模式为"蜱叮咬-首发病例-体液、排泄物-续发病例"。69.8%的病例存在中等和严重的家庭负担,最严重的是经济负担(88.9%)。影响家庭负担的因素是婚姻状况和文化程度(P<0.05)。结论居住在丘陵/山区的高龄农民为SFTS的高危人群,季节发病明显。存活病例和死亡病例的主要差异在于呕血和发病前家有老鼠。县级及以下医院诊断能力低、就诊次数多,确诊时间延长从而加重家庭负担。应加强培训和宣传,早发现、早诊断、早治疗。Objective To investigate and analyze the characteristics and family burden of severe fever with thrombocytopenia syndrome(SFTS) in confirmed cases in Hefei, so as to provide the evidence for scientific and effective prevention and control. Methods The epidemiological questionnaire and family burden questionnaire of SFTS in confirmed cases were analyzed retrospectively. Results From 2014 to 2019, 133 cases were confirmed in Hefei, with the positive rate of 43.75% by laboratory, 22 cases died, and the fatality rate was 16.5%. 4 counties in Hefei were higher incidence, but there was no statistically significant difference on the fatality rate(X^(2)=1.230, P=0.312). The epidemic season with 75.2% of cases was from April to July. There was no significant difference in the average age of onset between death and survival(Z=-1.337, P=0.183). 78.2% of cases were farmers, 85.7% of cases lived in hilly/mountainous areas one month before the onset, 78.9% of cases had outdoor activities in the two weeks before onset, and 15.8% of cases had a clear tick bite history. There was statistically significant difference(X^(2)=7.037, P=0.030) on the presence of mice in the home before the onset for survival and death. The first symptom of the cases was fever(99.2%). Most cases had the non-specific symptoms, such as fatigue(81.2%), and chills(61.7%) and loss of appetite(55.6%). There was no significant difference in hematemesis between survival and death(X^(2)=5.992, P=0.014). The median day from onset to diagnosis was 5 days with mean 2.29 times for seeking medical treatment. The diagnosis rate in municipal hospital and above was 86.3%. The transmission pattern of cluster outbreaks was "tick bite-first case-fluid body, feces-subsequent case". Medium or severe family burden was present in 69.8% of cases. The most serious was financial burden(88.9%). The factors influencing family burden were marital status and educational level(P< 0.05). Conclusion Elder farmers living in hilly/mountainous areas are the high-risk group, with obvious se

关 键 词：发热伴血小板减少综合征 发病特征 家庭负担 

分 类 号：R195.4[医药卫生—卫生统计学]