大理州云南不明原因猝死干预效果评价  

Effect of the comprehensive intervention measures on Yunnan unexplained sudden death in Dali Prefecture

作　　者：唐雪 习严梅[2] 马琳 孙梦遥[2] 杨永鹏 董毅 秦明芳[2] 王跃兵 Tang Xue;Xi Yanmei;Ma Lin;Sun Mengyao;Yang Yongpeng;Dong Yi;Qin Mingfang;Wang Yuebing(School of Public Health,Dali University,Dali 671000,China;Yunnan Provincial Key Laboratory of Natural Epidemic Disease Prevention and Control Technology,Yunnan Institute for Endemic Disease Control and Prevention,Dali 671000,China)

机构地区：[1]大理大学公共卫生学院,大理671000 [2]云南省地方病防治所,云南省自然疫源性疾病防控技术重点实验室,大理671000

出　　处：《中华地方病学杂志》2023年第1期41-46,共6页Chinese Journal of Endemiology

基　　金：国家自然科学基金(81960573、81460285);云南省科技厅应用基础研究计划青年项目(2018FD111);徐建国院士工作站项目(2018IC155);云南省地方病防治所青年人才资助培养计划(YIEDC-G202104)。

摘　　要：目的评价云南省大理州云南不明原因猝死(简称云南猝死)病区推行的综合性干预措施效果,为完善防治措施提供科学依据。方法自2010年,云南省针对云南猝死的病因模式,在病区推行综合性干预措施。2019年7月,在大理州鹤庆、祥云、云龙、洱源、剑川、宾川、南涧共7个县的31个云南猝死发病自然村,分别选取发生过云南猝死的47户家庭作为病例家庭和未发生过云南猝死的23户家庭作为对照家庭。对病例家庭和对照家庭采用统一调查表进行入户问卷调查,了解"发生第1例猝死病例时"与"当前"两个时间点家庭的基本情况、经济状况、膳食结构、健康素养等。结果当前病例家庭年收入(中位数,20492.6元)明显高于发生第1例猝死病例时(3883.4元),差异有统计学意义(Z=-5.27,P<0.001)。当前病例家庭主食粮为大米(76.6%,36/47);发生第1例猝死病例时,病例家庭中吃不饱的家庭占23.4%(11/47),当前病例家庭已没有吃不饱的情况。病例家庭当前与发生第1例猝死病例时相比,饮食习惯方面:吃毒沟褶菌人数占比由19.0%(39/205)降至0(0/190),吃野果人数占比由17.1%(35/205)降至9.5%(18/190),喝生水人数占比由55.1%(113/205)降至42.1%(80/190),差异均有统计学意义(χ^(2)=22.37、4.90、6.86,均P<0.05)。生活习惯及健康意识方面:饭前便后勤洗手人数占比由9.8%(20/205)升至41.6%(79/190),不过度劳累人数占比由16.6%(34/205)升至34.2%(65/190),喷农药时做好防护人数占比由7.3%(15/205)升至21.6%(41/190),差异均有统计学意义(χ^(2)=53.17、33.94、16.48,均P<0.001);如厕习惯方面:野外如厕人数占比由75.6%(155/205)降至9.5%(18/190),差异有统计学意义(χ^(2)=175.21,P<0.001)。发生第1例猝死病例时,病例家庭吃毒沟褶菌、野外如厕人数占比均高于对照家庭(χ^(2)=22.37、23.70,均P<0.001),饭前便后勤洗手、不过度劳累人数占比均低于对照家庭(χ^(2)=7.38、4.93,均P<0.05)。结�Objective To evaluate the effect of comprehensive intervention measures on Yunnan unexplained sudden death(YUSD)in Dali Prefecture,Yunnan Province,and to provide scientific basis for improving the prevention and control measures.Methods Since 2010,Yunnan Province had implemented comprehensive intervention measures in ward areas according to the etiological pattern of YUSD.In July 2019,47 families with YUSD were selected as case families and 23 families without YUSD were selected as control families in 31 natural villages of Heqing,Xiangyun,Yunlong,Eryuan,Jianchuan,Binchuan and Nanjian counties of Dali Prefecture.A unified questionnaire was used to investigate the basic information,economic status,dietary structure,and health literacy of the families during the two periods of"the first sudden death case"and"the present".Results The annual household income of the case families at present(median,20492.6 yuan)was significantly higher than that of the first sudden death case(3883.4 yuan),and the difference was statistically significant(Z=-5.27,P<0.001).At present,rice(76.6%,36/47)was the main diet of the case families;at the time of the first sudden death case,23.4%(11/47)of the case families could not eat enough,and there was no such situation in the case families at present.Compared with the time of the first sudden death case,the dietary habits of the case families at present were as follows:the proportion of eating Trogia venenata decreased from 19.0%(39/205)to 0(0/190),the proportion of eating wild fruit decreased from 17.1%(35/205)to 9.5%(18/190),and the proportion of drinking raw water decreased from 55.1%(113/205)to 42.1%(80/190),and the differences were statistically significant(χ^(2)=22.37,4.90,6.86,P<0.05).Lifestyle and health awareness:the proportion of those who washed their hands before meals and after using the toilet increased from 9.8%(20/205)to 41.6%(79/190),those who did not overwork increased from 16.6%(34/205)to 34.2%(65/190),and those who took good protection when spraying pesticides increased f

关 键 词：云南不明原因猝死 影响因素 干预评价 

分 类 号：R541.78[医药卫生—心血管疾病]