| | | 山东省肾综合征出血热死亡病例分析
| | 预防医学论文
作者：李健，王志强，胡茂红，赵仲堂
【关键词】 肾综合征出血热；死亡原因；鼠类
摘要： 目的预防医学论文 探讨山东省2004～2005年肾综合征出血热(Hemorrhagic Fever with Renal Syndrome,HFRS)病例的预防医学论文死亡原因，以便采取相应对策。方法 按中国疾病预防控制中心《全国流行性出血热监测方案》中的个案调查表对山东省2004～2005年全部HFRS死亡病例进行调查，并进行统计学分析。结果 山东省2004，2005年HFRS病死率分别比前一年上升9545％和232%,死亡病例平均年龄为5115岁，农民占7778%，男女性别比例26∶1。对41例进行了特异性抗体检测，阳性率为7561%。大部分病例临床症状不典型，从发病到就诊时间间隔平均为393d，死亡前有鼠类接触史。结论 山东省2004，2005年HFRS病死率有上升趋势；病例症状不典型、就诊时间晚、诊疗水平低和经济状况是造成病死率较高的重要原因；HFRS病死率升高可能是由于姬鼠型病例增多和病毒变异、毒力增加引起。
关键词：肾综合征出血热；死亡原因；鼠类
Analysis on death case of hemorrhagic fever with renal syndrome in Shandong province
Abstract： Objective To discuss the death causes of hemorrhagic fever with renal syndrome( HFRS) cases in Shandong province from 2004 to 2005 and make effective measures to reduce the death cases of HFRS. Methods Data on the HFRS death cases in Shandong province from 2004 to 2005 was collected according to the National Epidemic Hemorrhagic Fever Monitoring Project published by Chinese Center for Disease Control and Prevention. Database was set up and analyzed statistically. Results The fatality rates raised 95.45% and 2.32% in 2004 and 2005 compared with the year before in Shandong province.Death cases mainly occurred in November. With the average age of 51．15, the death cases were mainly peasants containing 77.78%. Male death cases were obviously more than those of female with the ratio 2.6 to 1.41.Serum specimens were detected and the positive rate was 75.61%. Most cases had atypical clinical symptoms. The average time was 3.93 days from falling ill to seeing doctor. Most of the cases touched mice before death. Conclusion The fatality rates have the potential to rise in Shandong province in the years of 2004 and 2005. Atypical symptoms, delaying to see doctor, low level in diagnosing and treating and poor economy conditions are the main death causes of HFRS．The rising ratio of Hataan typus cases, virus variation and virulence increase may be the important reasons of the increase of fatality rates.
Key words： hemorrhagic fever with renal syndrome(HFRs);death causes;mice
肾综合征出血热（Hemorrhagic Fever with Renal Syndrome, HFRS)是一种以发热、出血和肾功能损害为主要临床特征，严重危害人类生命与健康的自然疫源性疾病。该病分布于世界上30多个国家和地区，近年来疫区有不断扩展之势〔1-3〕。中国是世界上HFRS的高发病国家，流行期间病死率高达30%〔4〕，累计发病超过100万，占全球报告病例的90％以上。山东省为HFRS高发省份，发病数约占全国的1/3左右〔5〕。为探讨HFRS的死亡原因，更好的采取应对措施，现将山东省2004～2005年HFRS死亡病例分析如下。
1 材料与方法
11 疫情资料 为2004和2005年山东省内各县（市、区）网络直报资料；死亡病例个案调查按中国疾病预防控制中心《全国流行性出血热监测方案》中的出血热个案调查表进行。
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