云南不明原因猝死病区人群毒沟褶菌采食行为调查  

Investigation of incidence of gathering and eating Trogia venenata among populations in communities affected by the Yunnan unexplained sudden death

作　　者：习严梅 唐雪[1] 马琳[1] 孙梦遥 杨永鹏 董毅[1] 秦明芳 王跃兵[1] Xi Yanmei;Tang Xue;Ma Lin;Sun Mengyao;Yang Yongpeng;Dong Yi;Qin Mingfang;Wang Yuebing(Yunnan Provincial Key Laboratory of Natural Epidemic Disease Prevention and Control Technology,Office of Health Emergency of Yunnan Institute for Endemic Disease Control and Prevention,Dali 671099,China)

机构地区：[1]云南省地方病防治所卫生应急办公室、云南省自然疫源性疾病防控技术重点实验室,大理671099

出　　处：《中华急诊医学杂志》2025年第1期90-95,共6页Chinese Journal of Emergency Medicine

基　　金：国家自然科学基金项目(81960573);云南省技术创新人才培养对象项目(202405AD350026);云南省“兴滇英才支持计划”医疗卫生人才专项;徐建国院士工作站项目(2019YS08);云南省地方病防治所青年人才资助培养计划(YIEDC-G202104)。

摘　　要：目的调查云南不明原因猝死(简称云南猝死)病区人群对毒沟褶菌认知及采食情况,为云南猝死的病因研究提供依据,同时为毒沟褶菌中毒防控措施的制定打下基础。方法采用病例对照研究,2018—2021年在云南省25个县的90个云南猝死发病自然村内,分别选取云南猝死家庭作为病例家庭和未发生云南猝死的家庭作为对照家庭,对照选取采用方便抽样法(对照组∶病例组=3∶1)。通过问卷调查了解病例家庭和对照家庭毒沟褶菌采食、食用后症状等。计数资料采用频数(百分比)描述,组间比较采用χ^(2)检验或Fisher确切概率法。结果共发放711份调查问卷,回收率100%,其中病例家庭175户,对照家庭536户。80.82%的病区自然村附近有毒沟褶菌分布;711户家庭中15.89%食用过毒沟褶菌,以炒吃(53.10%)为主,其次为煮吃(29.20%)、先煮后炒(15.93%)和蒸吃(1.77%);94.69%的家庭食用新鲜子实体;69.02%的家庭1年不超过3次;病例家庭的食用率高于对照家庭。113户有毒沟褶菌食用史的家庭中,35.40%出现恶心、呕吐、四肢酸痛等不适症状。分别以来源、烹饪方式、子实体状态和食用频次分组,比较各组食用后受罹家庭所占比例的差异,食用频次高(≥3次/年)的受罹家庭比例高于食用频次低(<3次/年)。在421例云南不明原因猝死病例中63例在死前明确有毒沟褶菌食用史,其中食用时间在该蘑菇中毒一个最长潜伏期(14 d)内有43例。结论80.82%的云南不明原因猝死病区有毒沟褶菌分布,16.67%的人群有采食史,以炒食或煮食新鲜子实体为主。14.96%的云南不明原因猝死病例死前食用过毒沟褶菌,进一步证实了该蘑菇中毒是云南猝死的重要危险因素,我省仍有必要继续加强禁食毒沟褶菌的健康宣教。Objective This study investigated the awareness and consumption of Trogia venenata among populations in regions affected by Yunnan unexplained sudden death(YUSD).The findings aim to support etiological research on YUSD and contribute to the formulation of preventive measures against Trogia venenata poisoning.Methods This study was a case-control study.From 2018 to 2021,surveys were conducted in 90 villages across 25 counties within YUSD-affected areas in Yunnan Province.Households with YUSD cases were designated as case households,whereas households without YUSD cases served as controls,ande were selected through convenience sampling at a 3:1 ratio.An enhanced questionnaire was designed to collect information on the consumption of Trogia venenata,and symptoms following consumption.Frequency data were presented as percentages,and group comparisons were conducted usingχ^(2)tests or Fisher’s exact tests.Results A total of 711 questionnaires were collected(response rate:100%),comprising 175 case households and 536 control households.Trogia venenata was present in 80.82%of the villages surveyed.Among the 711 households,15.89%reported consuming Trogia venenata,primarily through stir-frying(53.10%),followed by boiling(29.20%),boiling and stir-frying(15.93%),and steaming(1.77%).Most households(94.69%)consumed fresh fruiting bodies,with 69.02%consuming them fewer than three times annually.The consumption rates were higher among the case households than among the control households.Of the 113 households with a history of Trogia venenata consumption,35.40%reported symptoms such as nausea,vomiting,and limb soreness.The proportions of affected families in each group were compared according to their source,cooking method,fruiting body status and consumption frequency.The proportion of affected families with high consumption frequency(≥3 times/year)was higher than that with low consumption frequency(<3 times/year).Among 421 YUSD cases,63 cases(14.96%)had a history of Trogia venenata consumption before death,with 43 cases s

关 键 词：云南不明原因猝死 毒沟褶菌 态度 调查 

分 类 号：R54[医药卫生—心血管疾病]