發(fā)布時(shí)間：2018-08-07 18:26

【摘要】：目的：采用動(dòng)力學(xué)模型模擬長(zhǎng)沙市甲型H1N1流感大流行,并評(píng)估隔離、治療患者、疫苗接種等防控策略的效果。 方法：根據(jù)甲型H1N1流感疾病特征和長(zhǎng)沙市人口學(xué)特點(diǎn),建立易感者-潛伏期-顯性/隱性感染者-移出者(susceptible-exposed-infectious/asymptomatic-removed, SEIAR)模型,對(duì)長(zhǎng)沙市甲型H1N1流感大流行疫情進(jìn)行模擬,采用長(zhǎng)沙市實(shí)際疫情數(shù)計(jì)算模型中的關(guān)鍵參數(shù)。在SEIAR模型基礎(chǔ)上,引入隔離、治療患者、疫苗接種等措施,構(gòu)建易感者-潛伏期-顯性/隱性感染者-移出者-隔離者(susceptible-exposed-infectious/asymptomatic-removed-quarantine, SEIARQ)模型、帶治療患者措施的模型、易感者-潛伏期-顯性/隱性感染者-移出者-隔離者(susceptible-exposed-infectious/asymptomatic-removed-vaccination, SEIARV)模型、以及綜合干預(yù)措施的模型。采用軟件Matlab7.1和Berkeley Madonna8.3.18模擬有、無干預(yù)措施下的流感大流行疫情,并利用累計(jì)罹患率、累計(jì)感染率等指標(biāo)評(píng)估干預(yù)的效果。 結(jié)果：甲型H1N1流感的平均潛伏期為2.1天,平均病程為5.3天,隱性感染比例為41.54%,重癥病例比例為3.11%,病死率為0.33%。長(zhǎng)沙市甲型H1N1流感大流行的基本再生數(shù)為1.81,無干預(yù)情況下大流行導(dǎo)致的長(zhǎng)沙市全人口的累計(jì)感染率為73.98%、累計(jì)罹患率為43.25%。隔離、治療患者、疫苗接種措施均具有較好的疫情控制效果,而且隔離力度和疫苗接種力度越大、防控效果越好。綜合干預(yù)措施效果的優(yōu)劣順序分別為：“隔離+治療患者+疫苗接種”、“疫苗接種+治療患者”、“隔離+治療患者”、“隔離+疫苗接種”。通過實(shí)際干預(yù)后,人群實(shí)際累計(jì)感染率27.81%,實(shí)際干預(yù)措施能夠?qū)⒗塾?jì)感染率降低73.60%。 結(jié)論：SEIAR模型可以較好地模擬流感大流行的特點(diǎn)。綜合干預(yù)措施的效果優(yōu)于單項(xiàng)措施。藥物干預(yù)措施的組合效果優(yōu)于非藥物干預(yù)措施。流感大流行時(shí)可以采取“隔離+治療患者+疫苗接種”的綜合干預(yù)措施。
[Abstract]:Objective: to simulate the influenza A (H1N1) pandemic in Changsha by using a dynamic model and to evaluate the effectiveness of isolation, treatment of patients, vaccination and other prevention and control strategies. Methods: according to the disease characteristics of influenza A (H1N1) and the demographic characteristics of Changsha, a model of susceptible-exposed-infective tomatic-removed-removed( SEIAR) was established to simulate the influenza A (H1N1) pandemic in Changsha. The key parameters in the calculation model of the actual epidemic situation in Changsha City were adopted. On the basis of SEIAR model, isolation, treatment, vaccination and so on were introduced to construct susceptible-exposed-infection-removed-quarantine (SEIARQ) model with treatment measures. Susceptible-exposed-infection-removed-accineration (SEIARV) model and comprehensive intervention model. Matlab7.1 and Berkeley Madonna8.3.18 were used to simulate the influenza pandemic without intervention, and the cumulative attack rate and cumulative infection rate were used to evaluate the effectiveness of the intervention. Results: the average incubation period and duration of influenza A (H1N1) were 2.1 days, 5.3 days, 41.54%, 3.11% and 0.33% respectively. The basic regenerative number of influenza A H1N1 pandemic in Changsha is 1.81. The cumulative infection rate of the whole population in Changsha is 73.98 and the cumulative attack rate is 43.25 under the condition of no intervention. Isolation, treatment of patients, vaccination measures have a better effect of epidemic control, and the greater the isolation and vaccination, the better the effect of prevention and control. The results of comprehensive intervention were as follows: vaccinations for patients treated with isolation, vaccinations for patients treated with vaccines, and vaccinations for patients with isolation. After actual intervention, the actual cumulative infection rate of the population was 27.81%, and the actual intervention measures could reduce the cumulative infection rate by 73.60%. ConclusionSeiar model can well simulate the characteristics of influenza pandemic. The effect of comprehensive intervention is better than that of single measure. The combination effect of drug intervention is superior to that of non-drug intervention. A comprehensive intervention can be taken in the event of an influenza pandemic, such as vaccination of isolated treatment patients.
【學(xué)位授予單位】：中南大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R181.3

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