本文選題：腎綜合征出血熱 + 流行特征�。� 參考：《山東大學》2008年碩士論文

【摘要】： 腎綜合征出血熱(Hemorrhagic Fever with Renal Syndrome,HFRS)是一種自然疫源性疾病,該病以亞洲、歐洲大陸多發(fā)。其中流行性出血熱(EHF,HFRS的一種)主要流行于亞洲地區(qū),而發(fā)病最多的是中國。HFRS是由漢灘病毒引起的,經研究證實分為9個血清型,我國主要是漢坦型和漢城型流行。目前該病在我國流行仍十分嚴重,并且出現(xiàn)了新的流行特征:①發(fā)病例數(shù)上升明顯;②現(xiàn)有疫區(qū)范圍不斷擴大,新疫區(qū)時有出現(xiàn);③大中城市流行強度上升,疫情向大中城市蔓延;④流行的季節(jié)性發(fā)生變化,除冬季外,其它季節(jié)的月發(fā)病差異不明顯。 研究目的:莒南縣以低海拔的平原、丘陵為主,境內河流密布;平邑縣是典型的山區(qū)地形,海拔較高,河流較少。兩縣相距100余公里,但地理生態(tài)環(huán)境相差大,且兩縣HFRS發(fā)病率都較高,都是我國HFRS監(jiān)測點。本研究利用兩縣歷年HFRS發(fā)病資料、宿主動物監(jiān)測資料等,應用描述流行病學研究方法,探討具有不同地理特征與生態(tài)環(huán)境HFRS疫源地的異質性及其影響因素,以便為在不同地理特征與生態(tài)環(huán)境的疫區(qū)進行HFRS的預防和控制提供科學的理論依據(jù)。 本研究結果表明: 1.莒南縣1975年9月1日～2005年12月1日共發(fā)生HFRS病例16118例,平均發(fā)病率58.61/10萬,累計病死203例,平均病死率1.26%。其中男性占67.24%,15～64歲占總發(fā)病數(shù)88.05%,農民占總病例的88.92%;平邑縣1980年12月～2005年12月,累計發(fā)生HFRS病例9384例,平均發(fā)病率29.48/10萬,死亡265例,平均病死率2.82%。男性占64.96%,35～45歲人群發(fā)病所占比例最高(33.23%);農民占88.99%。 2、兩縣HFRS的年發(fā)病水平呈周期性變化,平邑縣流行周期約3～5年,莒南縣約5～7年;兩縣均經歷了秋冬季的單峰型→以秋冬峰為主的雙峰型→以春峰為主的雙峰型的季節(jié)性波動;總體上,兩縣HFRS秋冬季病死率大于春季,病死率總的趨勢隨時間在下降。 3、兩縣疫源地先后經歷了由姬鼠型散發(fā)階段→姬鼠型暴發(fā)流行階段→家鼠、姬鼠混合型散發(fā)流行階段→家鼠型為主的混合型暴發(fā)→家鼠型為主的混合型散發(fā)階段的變化過程,到2005年12月兩縣仍處在家鼠型為主的混合型散發(fā)階段。鼠密度高峰在第三季度,鼠帶毒率第4季度最高。 4、HFRS病例的分布在兩縣鄉(xiāng)鎮(zhèn)有明顯的聚集性。高發(fā)區(qū)多位于地勢低洼,易受內澇及河水流過的平原地帶;中發(fā)病區(qū),主要分布在干旱丘陵地區(qū)和低山林區(qū);低發(fā)病區(qū)域多分布在較高海拔的干旱山區(qū),兩縣HFRS的發(fā)病也有一定的家庭聚集現(xiàn)象。 結論: (1)平邑縣和莒南縣HFRS的流行都經歷了以下5個過程:散發(fā)→局部流行→暴發(fā)→廣泛流行→散發(fā)階段,但莒南縣有一個HFRS的持續(xù)高發(fā)流行階段(1990～1994年)。兩縣疫源地都經歷了由HTN型→HTN型為主的混合型→SEO型為主的混合型的疫源地演變過程;兩縣病死率總的趨勢在下降,秋冬季病死率明顯高于春季病死率。 (2)兩縣的年發(fā)病率、病死率、流行周期存在差異。莒南縣的年發(fā)病率明顯高于平邑縣的年發(fā)病率,平邑縣病死率則高于莒南縣病死率。平邑縣流行周期約為3～5年,莒南縣HFRS流行周期約為5～7年, (3)HFRS發(fā)病率隨地形地貌、生態(tài)景觀等空間環(huán)境的改變而發(fā)生變化。HFRS疫區(qū)有從莒南縣所在的東南平原河網地區(qū)向西北部山區(qū)丘陵地帶遷移的趨勢。
[Abstract]:Hemorrhagic Fever with Renal Syndrome (HFRS) is a natural epidemic disease, which is widely distributed in Asia and Europe, among which epidemic hemorrhagic fever (one of EHF, HFRS) is mainly prevalent in Asia, and the most prevalent is that Chinese.HFRS is caused by Hantaan virus. It has been confirmed to be divided into 9 serotypes by study. Our country is mainly the Hantaan type and Seoul type popular. At present, the epidemic in China is still very serious, and there are new epidemic characteristics: (1) the number of cases is rising obviously; (2) the scope of the epidemic area is expanding, the new epidemic area has appeared; (3) the epidemic intensity of the large and middle cities is rising, the epidemic situation spreads to the large and medium cities; (4) the seasonal change of epidemic situation has changed. Except for winter, there was no significant difference in the incidence of other seasons.
Research purposes: Junan county is a low altitude plain, mainly hilly, and the inland river is densely distributed; Pingyi county is a typical mountainous terrain, high altitude, and less rivers. Two counties are more than 100 kilometers apart, but the geographical and ecological environment is different, and the incidence of HFRS in two counties is high, all of which are HFRS monitoring points in China. This study uses the data of the incidence of HFRS in two counties for the year. In order to provide scientific theoretical basis for the prevention and control of HFRS in the epidemic areas of different geographical features and ecological environment, the heterogeneity and its influencing factors with different geographical features and ecological environment HFRS foci are discussed by descriptive epidemiological methods.
The results of this study show that:
1. Junan county from September 1, 1975 to 1 December 2005, there were 16118 cases of HFRS cases, the average incidence of 58.61/10 million, the cumulative mortality of 203 cases, the average fatality rate of 1.26%. is 67.24%, 15~64 years old accounted for 88.05%, the farmers accounted for 88.92% of the total cases, and Pingyi County December 1980 to December 2005, the cumulative incidence of 9384 cases of HFRS, the average hair The morbidity rate was 29.48/10 million, 265 cases died, the average mortality rate was 2.82%., the male accounted for 64.96%, the proportion of the 35~45 year old population was the highest (33.23%), and the farmers accounted for 88.99%.
2, the annual incidence of HFRS in two counties showed periodic changes, the epidemic period of Pingyi county was about 3~5 years, and Junan county was about 5~7 years. The two counties all experienced the seasonal fluctuation of the single peak type of autumn winter and the Shuangfeng type to the spring peak dominated by the autumn winter peak. In general, the mortality rate of the two counties was greater than that in spring, and the total trend of mortality was the following. Time is falling.
3, the two county foci have experienced the change process of the mixed sporadic phase from the stage of the Apodemus type to the outbreak stage of the Apodemus type, the rat, the mixed type of the Apodemus, the mixed type of the rat type and the rat type, and the mixed sporadic phase of the rat type. In December 2005, the two counties are still in the mixed type of the rat type. The peak rate in the third quarter was highest in the fourth quarter.
4, the distribution of HFRS cases in the two counties and towns has obvious aggregation. The high incidence area is located in the low lying land, easily subject to the waterlogging and river flowing through the plain area; the middle incidence area is mainly distributed in the arid hilly area and the low mountain forest area; the low incidence area is mostly distributed in the high altitude arid mountain area, and the incidence of the two county HFRS is also a certain family gathering now. Elephant.
Conclusion:
(1) the epidemic of HFRS in Pingyi and Junan counties all experienced the following 5 processes: sporadic, local epidemic, outbreak, widespread epidemic and sporadic phase, but Junan county has a continuous high epidemic stage of HFRS (1990~1994 years). All two county foci have experienced a mixed type of mixed type of type of type HTN to SEO mainly of type to HTN type. The overall trend of mortality in two counties is decreasing, and the mortality in autumn and winter is significantly higher than that in spring.
(2) the annual incidence, fatality rate and epidemic cycle of the two counties were different. The annual incidence of Junan county was obviously higher than the annual incidence of Pingyi County, and the fatality rate in Pingyi county was higher than that of Junan county. The epidemic cycle of Pingyi county was about 3~5 years, and the epidemic cycle of HFRS in Junan county was about 5~7 years.
(3) the incidence of HFRS changes with the change of the spatial environment, such as landform, landform, landscape, ecological landscape, and so on. The.HFRS epidemic area has a tendency to migrate from the river network area of the southeast plain to the mountainous and hilly areas of the northwest of Junan.

【學位授予單位】：山東大學
【學位級別】：碩士
【學位授予年份】：2008
【分類號】：R181.3

【參考文獻】

相關期刊論文 前10條

1 楊衛(wèi)紅,張云智,張海林,米竹青,車忠民,李建榮;昆明市2000年嚙齒動物自然感染腎綜合征出血熱病毒的調查[J];地方病通報;2003年01期

2 朱福林,李文,楊林;濟南市1995～1999年流行性出血熱監(jiān)測分析[J];中國公共衛(wèi)生管理;2001年05期

3 韓悅,石有昌,劉敏,馬環(huán),范俐娟;遼寧省1991-2000年流行性出血熱疫情分析[J];疾病監(jiān)測;2001年10期

4 王志強,康殿民,王宇路,王梅,翟文濟,薛付忠;山東省腎綜合征出血熱最優(yōu)化社區(qū)干預模式的研究[J];疾病控制雜志;2005年06期

5 何丕山，，李學剛,王林彬;莒南縣腎綜合癥出血熱監(jiān)測及防制[J];江蘇預防醫(yī)學;1999年01期

6 王麟士;腎綜合征出血熱的研究近況[J];臨床薈萃;1998年01期

7 楊占清,俞守義;腎綜合征出血熱病毒傳播途徑的研究進展[J];實用醫(yī)藥雜志;2005年01期

8 張玉軍,薛付忠,賈紅英,陳桂興;臨沂市腎綜合征出血熱時空流行動態(tài)混沌分形分析[J];山東醫(yī)科大學學報;2001年04期

9 薛付忠,王潔貞,范麗煒,王振光;疾病空間異質性定量分析方法及其應用[J];山東大學學報(醫(yī)學版);2002年06期

10 王志強,尤向東,王宇路,王顯軍,康殿民,王玫,李忠政;山東省1998～2002年腎綜合征出血熱宿主帶病毒監(jiān)測[J];預防醫(yī)學文獻信息;2003年06期

相關博士學位論文 前1條

1 薛付忠;人類群體遺傳空間結構異質性理論與定量分析方法研究[D];山東大學;2005年

本文編號：1885318