本文選題：脊髓灰質(zhì)炎 + 實(shí)驗(yàn)室感染��； 參考：《中國疾病預(yù)防控制中心》2017年碩士論文

【摘要】：研究背景脊髓灰質(zhì)炎(簡稱脊灰)是一種嚴(yán)重危害人類的急性病毒性傳染病[1],引起脊髓灰質(zhì)炎的病原體是脊灰病毒。脊灰病毒是一種人腸道病毒,感染人體后,通過侵襲脊髓的運(yùn)動神經(jīng)元引起典型麻痹癥狀。脊髓灰質(zhì)炎是目前全球第二個正在消滅的傳染性疾病。中國從事脊灰相關(guān)防控工作的是各省級疾控中心的脊灰網(wǎng)絡(luò)實(shí)驗(yàn)室,這些網(wǎng)絡(luò)實(shí)驗(yàn)室的日常工作包括脊灰病毒細(xì)胞培養(yǎng)、病毒分離、脊灰病毒的中和定型及型內(nèi)鑒定工作,還包括對急性弛緩性麻痹(AFP)病例、接觸者、流動人口、健康人群及環(huán)境中和樣本的檢測分析[2],為消除和維持我國無脊灰狀態(tài)發(fā)揮著重要作用。在脊灰實(shí)驗(yàn)室工作中,對于脊灰實(shí)驗(yàn)室工作人員來說,存在意外暴露和接觸感染性樣本或病毒的較高風(fēng)險(xiǎn)。同時,由于我國周邊少數(shù)國家仍然存在脊灰野病毒流行,我國面臨著輸入脊灰疫情風(fēng)險(xiǎn)[3]。因此,作為高危職業(yè)人群,這些實(shí)驗(yàn)室工作人員仍然處于脊灰的威脅之中[4-5],其健康與否不僅關(guān)乎自身利益,也同樣關(guān)乎國家安全和社會穩(wěn)定。對脊髓灰質(zhì)炎病毒實(shí)驗(yàn)室工作人員實(shí)施免疫預(yù)防策略,是降低實(shí)驗(yàn)室人員感染并傳播脊灰病毒風(fēng)險(xiǎn)的重要手段之一。研究目的了解全國各省級疾控中心脊髓灰質(zhì)炎網(wǎng)絡(luò)實(shí)驗(yàn)室工作人員免疫接種情況和免疫意愿及其影響因素,為提出符合我國國情的適合脊髓灰質(zhì)炎網(wǎng)絡(luò)實(shí)驗(yàn)室工作人員的免疫策略提供參考,從實(shí)驗(yàn)室生物安全管理角度,為維持無脊灰狀態(tài)及消滅脊灰做出應(yīng)有貢獻(xiàn)。研究方法2016年10月-12月選取全國省級疾控中心脊髓灰質(zhì)炎網(wǎng)絡(luò)實(shí)驗(yàn)室從業(yè)人員為調(diào)查對象,采用問卷調(diào)查的方式,收集該人群基本信息、免疫接種情況、免疫意愿等資料,并利用SAS軟件及卡方檢驗(yàn)、精確概率法對免疫接種情況和免疫意愿進(jìn)行影響因素的統(tǒng)計(jì)學(xué)分析,以P0.05為差異有統(tǒng)計(jì)學(xué)意義。研究結(jié)果1.參與本次調(diào)查人數(shù)為77人,其中男性28人(36.4%),女性49人(63.6%);20～歲年齡組16人(20.8%),30～歲組33人(42.8%),40～歲組19人(24.7%),≥50歲9人(11.7%);初級職稱者17人(22.0%),中級職稱者30人(39.0%),副高職稱者17人(22.1%),正高職稱者13人(16.9%);大專及以下學(xué)歷10人(13.0%),本科及以上67人(87.0%)。人員整體素質(zhì)較高,配置合理。2.免疫接種情況及其影響因素完成脊髓灰質(zhì)炎基礎(chǔ)免疫的為60人(約占78%),17人基礎(chǔ)免疫情況不清楚(約占22%)。從事脊髓灰質(zhì)炎病毒工作后接種疫苗為66人(約占86%),11人接種記錄不完整(約占14%)。免疫影響因素..年齡與接種情況,卡方值(χ2=2.48),P0.05;職稱與接種情況,卡方值(χ2=2.51),P0.05;工作時間與接種情況,P0.0001;學(xué)歷與接種情況,卡方值(χ2=0.74),P=0.46;性別與接種情況,卡方值(χ2=0.46),P=0.50。3.接種疫苗意愿及其影響因素愿意接種疫苗共有75人,占全部人員的97.4%;選擇接種脊髓灰質(zhì)炎滅活疫苗(IPV)50人(占66.7%),選擇接種脊髓灰質(zhì)炎減毒活疫苗(0PV)25人(占33.3%);愿意在脊髓灰質(zhì)炎病毒中和抗體水平低和入職前時接種人數(shù)居多;對疫苗接種有顧慮的13人中,11人(占84.6%)擔(dān)心疫苗引起的不良反應(yīng)。以年齡、職稱、學(xué)歷、性別、工作時間為影響因素對免疫意愿進(jìn)行分析顯示,年齡與疫苗選擇情況,卡方值(χ2=l.78),P0.05。結(jié)論研究結(jié)果顯示,中國脊灰網(wǎng)絡(luò)實(shí)驗(yàn)室人員免疫接種情況較好,其中完成≥3劑次者占41%,且接種信息記錄完整;在接種意愿方面,該人群更傾向于在入職時和脊灰中和抗體水平低時接種IPV疫苗�？傮w來說,中國脊灰網(wǎng)絡(luò)實(shí)驗(yàn)室工作人員免疫現(xiàn)狀較好,具備了提出和制定相應(yīng)免疫策略的良好基礎(chǔ)。主要存在問題(1)部分工作人員基礎(chǔ)免疫接種信息記錄不清;(2)部分工作人員工作后接種脊灰疫苗信息不完整;(3)大部分工作人員愿意接種IPV疫苗,但是現(xiàn)在提供的接種疫苗為OPV疫苗;(4)缺乏針對脊髓灰質(zhì)炎實(shí)驗(yàn)室工作人員的規(guī)范完整的免疫接種策略;(5)缺乏對脊髓灰質(zhì)炎實(shí)驗(yàn)室人員感染脊髓灰質(zhì)炎感染風(fēng)險(xiǎn)的評估。對策建議(1)建立適合我國國情的規(guī)范完整的脊髓灰質(zhì)炎實(shí)驗(yàn)室人員免疫接種策略。(2)定期監(jiān)測脊髓灰質(zhì)炎網(wǎng)絡(luò)實(shí)驗(yàn)室人員體內(nèi)抗體水平,結(jié)合接種情況合理評估其感染脊髓灰質(zhì)炎的風(fēng)險(xiǎn)。(3)將IPV納入到脊髓灰質(zhì)炎實(shí)驗(yàn)室人員免疫規(guī)劃中。(4)完善疫苗可預(yù)防疾病的實(shí)驗(yàn)室人群免疫規(guī)劃策略。
[Abstract]:Background poliomyelitis (poliomyelitis) is an acute viral infectious disease ([1]), which is seriously harmful to human beings. Polio is the pathogen of poliomyelitis. Poliovirus is a human enterovirus, which infects the human body and causes typical paralysis by the motoneurons that invade the spinal cord. Poliomyelitis is second of the world. China's polio related prevention and control work is the polio network laboratory at the provincial CDC. The daily work of these network laboratories includes polio cell culture, virus isolation, neutralization and internal identification of poliovirus, and cases of acute flaccid paralysis (AFP). The detection and analysis of the migrants, the floating population, the healthy population and the environment and the sample [2] play an important role in eliminating and maintaining the polio free state of our country. In the polio laboratory work, there is a high risk of accidental exposure and exposure to infectious samples or viruses for the polio laboratory staff. China still exists polio virus epidemic, China faces the risk of polio epidemic [3]., so as high-risk occupations, these laboratory workers are still in the threat of polio [4-5]. Their health is not only related to their own interests, but also related to national security and social stability. The implementation of immunization prevention strategies is one of the important means to reduce the risk of infection and spread of poliovirus in laboratory personnel. The purpose of this study is to understand the immunization situation, the immune will and the influence factors of the staff of the poliomyelitis network laboratory at the provincial CDC, and to put forward the suitable spinal cord to meet the national conditions of our country. The immunization strategy of the network laboratory staff is provided for reference. From the laboratory biological safety management point of view, it is necessary to contribute to the maintenance of the state of polio free and the elimination of polio. The research method was selected by the national provincial CDC workers in the Network Laboratory of poliomyelitis in -12 month of October 2016. Methods, the basic information of the population, immunization, and the willingness to immunization were collected, and SAS software and chi square test were used to analyze the influence factors of immunization and the intention of immunization. The difference was statistically significant with the difference of P0.05. The number of 1. participants in this survey was 77, of which 28 men were male. (36.4%) 49 women (63.6%); 20 to age group 16 (20.8%), 30 to 33 (42.8%), 40 years old group 19 (24.7%), more than 50 years of 9 (24.7%); junior professional title person, secondary professional title person, senior professional title person, college and below educational background, undergraduate and above. The overall quality of the personnel was high. 60 people (about 78%) had completed the poliomyelitis basic immunization with a reasonable.2. immunization and its influencing factors. The basic immunity of 17 people was not clear (about 22%). 66 people (about 86%) were vaccinated after the poliovirus, 11 (about 14%) were inoculated (about 14%). The immune influence causes Age and inoculation, chi square value (chi 2=2.48), P0.05; title and vaccination status, chi square value (x 2=2.51), P0.05; working hours and inoculation conditions, P0.0001; education and inoculation, chi square value (chi square), P=0.46; sex and vaccination, chi square value (chi square), P=0.50.3. vaccination intention and its influence factors willing to vaccinate 75 People, 97.4% of all, 50 (66.7%) selected inoculation poliomyelitis inactivated vaccine (IPV), 25 (33.3%) inoculated poliomyelitis live attenuated vaccine (0PV), low level of poliovirus neutralization antibody and the number of inoculation before entry; 11 (84.6%) worried about the vaccine among the 13 people who were worried about the vaccination. The effects of age, title, educational background, sex and working time on immune willingness were analyzed, age and vaccine selection, chi square value (chi square 2=l.78). The results of P0.05. conclusion showed that the immunization of Chinese polio network laboratory personnel was better, with more than 3 doses of 41%, and inoculation information. The population was more inclined to inoculate the IPV vaccine at the time of entry and the low level of polio neutralization antibody. In general, the immune status of the workers in the Chinese polio network laboratory was better, and had a good basis for putting forward and formulating the corresponding immunization strategies. The main problems were (1) the basic immunity of some staff members. The inoculation information was not well documented; (2) the information on the inoculation of polio vaccine was incomplete after some staff work; (3) most of the staff were willing to vaccinate IPV vaccines, but the present vaccination was OPV vaccine; (4) a lack of standardized and complete immunization strategies for polio laboratory staff; and (5) lack of poliomyelitis. Assessment of the risk of poliomyelitis infection in laboratory staff. Recommendations (1) to establish a standardized and complete polio immunization strategy suitable for China's national conditions. (2) to regularly monitor the level of antibody in the network laboratory personnel of poliomyelitis, and to assess the risk of poliomyelitis in a reasonable manner in combination with the vaccination situation. (3) IPV was incorporated into the immunization program for poliomyelitis laboratory. (4) to improve the immunization strategy of vaccine population in laboratory population.

【學(xué)位授予單位】：中國疾病預(yù)防控制中心
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R186

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