中国媒介生物学及控制杂志

• 论著 • 上一篇    下一篇

茶陵县2000至2004年狂犬病及其相关危险因素病例对照研究

郭均安1,2;杨土保2;谭初明3;杜海涛4;李晓明4;盛剑锋3;杨忠3   

  1. 1湖南省株洲市卫生执法监督处洲;2中南大学公共卫生学院;3茶陵县疾病预防控制中心;4株洲市疾病预防控制中心
  • 出版日期:2005-04-20 发布日期:2005-04-20

A Case-control Study on Rabies with Its Relative Risk Factors in Chaling County,Hunan Province, From 2000 to 2004

GUO Jun-an*;YANG Tu-bao;TAN Chu-ming;et al*   

  1. Department of Execution and Supervision on Health Laws,Zhuzhou 412000,China
  • Online:2005-04-20 Published:2005-04-20

摘要: 目的 研究湖南省茶陵县狂犬病发生的相关危险因素,为现场干预研究提供科学依据。方法 以2000~2004年茶陵县全部狂犬病病例为研究对象,以与病例组具有同源犬伤暴露史的健康存活者为对照组,进行病例对照研究,统计学分析采用χ2检验。结果 病例组平均潜伏期为60d(9~412d),平均病程为2d(0~7d),其中头面部、手部和上肢、躯干和下肢受伤者平均潜伏期分别为28、52和77d,浅表伤口与深度伤口患者平均潜伏期分别为56和68d,有狂犬病疫苗接种史与无狂犬病疫苗接种史患者的平均潜伏期分别为39和62d。相关危险因素分析,未接种狂犬病疫苗(χ2=48.776,P<0.01,OR=41.67)、伤口部位接近中枢神经(χ2=35.143,P<0.01)、深度伤(χ2=6.800,P<0.05,OR=3.23)和未进行伤口处理(χ2=6.174,P<0.05,OR=2.84)等因素相对危险性明显高于对照组,差异均有显著统计学意义。结论 未接种狂犬病疫苗、接种非正规途径来源的狂犬病疫苗、伤口未处理、深度伤口、伤口位置靠近中枢神经等为茶陵县狂犬病发生的相关危险因素。应重点加强犬伤暴露后的伤口规范化处理及接种狂犬病疫苗等防制措施。

关键词: 狂犬病, 病例对照研究, 相关危险因素, 潜伏期

Abstract: Objective To study the relative risk factors of rabies in Chaling county,Hunan province to provide the scientific evidence for the field intervention. Methods With case-control study method,all the rabies cases which occurred in Chaling county,Hunan province from 2000 to 2004 were regarded as research objects and the healthy survivors who had been hurt by a dog in the same way were regarded as control. The results were analyzed with χ2 test. Results In case group,the average latent period was 60 days (9-412),the average course of disease was 2 days (0-7). The latent period of the cases which were hurt with head and face,hand and upper limbs,trunk and lower limbs was 28 days,52 days,and 77 days respectively. The average latent period of the cases with superficial wound and deep wound was 56 days and 68 days. The average latent period of the cases which were inoculated and not inoculated was 39 days and 62 days respectively. For the relative risk factors analyzed,there were significant difference in which the OR was very much higher in some factors,such as not inoculated (χ2= 48.776 ,P< 0.01 ,OR= 41.61 ),the vaccine from abnormal way used (χ2= 9.580 ,P< 0.05 ,OR= 10.64 ),the wound position close to the nerve center (χ2= 35.143 ,P< 0.01 ),deep wound (χ2= 6.800 ,P< 0.05 ,OR= 3.23 ),and the wound without treatment (χ2= 6.174 ,P< 0.05 ,OR= 2.84 ).Conclusion No incubated vaccine,the vaccine from abnormal way used,the wound without treatment,deep wound and the wound position close to the nerve center were the relative risk factors of rabies occurred in Chaling county,not inoculating RV,RV resources,deep wound and not offering wound management. It must attach importance to use prevention and control measures such as canonical method of wound treatment and the rabies vaccine inculated to prevent rabies when someone hurt by a dog.