浙江省人感染H7N9禽流感病毒感染水平研究

发布时间：2018-07-08 15:21

本文选题：H7N9禽流感 + 流感样病例　；参考：《宁波大学》2017年硕士论文

【摘要】：目的:1.分析浙江省人感染H7N9禽流感病例人群分布情况,掌握疾病发生的高危人群,获得H7N9病例的感染特征。2.根据浙江省流感样病例(ILI)和住院严重急性呼吸道感染病例(SARI)的流行病和病原的信息,获得我省轻症、重症呼吸道感染病例中H7N9病毒的感染水平。3.了解浙江省社区健康人群和涉禽职业暴露人群H7的抗体滴度水平,从而获得健康人群中H7N9的感染水平。4.通过以上几种人群的感染水平分析可以为制定和采取H7N9禽流感疫情的防制措施提供科学的依据。方法:1.收集并分析截至2016年6月浙江省所有H7N9病例的相关数据,从而了解H7N9病例的流行病学特征。运用Excel 2007录入并整理数据,SPSS18.0分析数据,Arg GIS软件制作地图,P0.05即有统计学意义。2.采集2013年至2015年浙江省16家ILI哨点医院和4家SARI哨点医院有禽类暴露史的ILI和SARI病例的标本,通过H7N9病毒的核酸检测,获得ILI和SARI病例中H7阳性患者。3.通过抽样调查采集社区健康人群和职业暴露人群的血清学标本并获得研究人群的基本信息,同时对采集的标本进行血凝抑制(HI)试验。抗体滴度≥1:80即为阳性。结果:1.截至2016年6月浙江省H7N9疫情已有四个流行季,累计报告病例数218例,病死率高达39.4%。浙江省H7N9病例主要集中在40~以上的人群,且40~岁以上的人群病死率较高(x2=21.899,P0.001);男性患者所占比例高于女性(1.8:1);离退休人员和农民在总病例数中所占比例高达62.4%;感染地在城市的病例数所占比例明显高于感染地在农村的比例,农村病例数所占比例不断增大(x2=27.072,P0.001)。有基础性疾病的患者所占比例较大,特别是高血压和糖尿病,病例患病率分别高达42.1%和18.8%,有基础性疾病的患者病死率明显高于没有基础性疾病的患者的病死率(x2=8.726,P=0.013)。发病前有活禽暴露史的患者所占比例较大,特别是有活禽市场暴露史的病例所占比重较大,占64.7%。2.2013年至2015年ILI病例中共监测到6例H7阳性患者,H7阳性率约为12/10万,SARI病例中共监测到3例H7阳性患者,H7阳性率约为60/10万。ILI和SARI病例中,3年的H7阳性率差异均没有统计学意义(x2=2.091,P=0.343,x2=1.973,P=0.473);男女之间H7阳性率差异均没有统计学意义(P=0.687,P=0.275);不同年龄段的H7阳性率不同(x2=12.334,P=0.001,x2=20.310,P0.001)。随着年龄的增大,ILI病例中H7阳性率也升高(x2=14.343,P=0.001);SARI病例中,40~年龄段和60~年龄段H7阳性率比低年龄段的H7阳性率高。3.3522例社区健康人群中有28例H7阳性患者,阳性检出率为0.8%,GMT为1:5.2;1559例涉禽职业人群中有32例H7阳性患者,阳性检出率为2.1%,GMT为1:6.8。社区健康人群与职业暴露人群的抗体阳性率差异有统计学意义(x2=14.646,P0.001),职业暴露人群的抗体滴度水平明显较高。结论:1.中老年男性、患有基础性疾病者、城市居民、农民或者离退休人员及发病前有活禽暴露史的患者所占比重较大。有基础性疾病的中老年人病死率较高。农村、自养禽暴露及有基础性疾病的患者所占比重有逐渐上升的趋势。2.ILI病例和SARI病例中均监测出极少数H7阳性患者,SARI病例中H7阳性率高于ILI病例中H7阳性率。3.社区健康人群中H7阳性检出率为0.8%,职业暴露人群中H7阳性检出率为2.1%,职业暴露人群H7抗体阳性检出率比社区健康人群高。
[Abstract]:Objective: 1. to analyze the distribution of people infected with H7N9 avian influenza in Zhejiang Province, to grasp the high risk population of the disease and obtain the infection characteristics of H7N9 cases, according to the information of influenza like cases (ILI) and hospitalized severe acute respiratory infection cases (SARI) in Zhejiang Province, and to obtain the cases of light disease and severe respiratory infection in our province. H7N9 virus infection level.3. understand the level of antibody titer of H7 in Zhejiang community healthy population and fowl occupational exposure population, so as to obtain H7N9 infection level in healthy population,.4. can provide scientific basis for formulating and taking H7N9 avian influenza epidemic prevention measures by analyzing the infection level of these groups. Method: 1. Collect and analyze the data of all H7N9 cases in Zhejiang province in June 2016 to understand the epidemiological characteristics of H7N9 cases. Using Excel 2007 to enter and organize data, SPSS18.0 analysis data, Arg GIS software map, P0.05 that is, statistically significant.2. collection from 2013 to 2015 16 ILI sentinel hospitals and 4 SARI Sentinel A sample of ILI and SARI cases of avian exposure history in the hospital. Through the nucleic acid detection of H7N9 virus, H7 positive patients in ILI and SARI cases were obtained by.3. sampling survey to collect the serological samples from the healthy and occupational exposed population of the community and to obtain the basic information of the population, and the blood coagulation inhibition (HI) test of the collected specimens was carried out. The antibody titer more than 1:80 was positive. Results: 1. as of June 2016, the H7N9 epidemic in Zhejiang province had four epidemic seasons, with a cumulative number of reported cases of 218 cases, the fatality rate was high in the H7N9 cases of 39.4%. in the population of more than 40~, and the mortality rate of people above 40~ was higher (x2=21.899, P0.001); the proportion of male patients was higher than that of women. (1.8:1); the proportion of retirees and farmers in the total number of cases is up to 62.4%; the proportion of cases in the urban areas is significantly higher than that in the rural areas, the proportion of rural cases is increasing (x2=27.072, P0.001). The proportion of patients with basic diseases is larger, especially hypertension and diabetes, cases of hypertension and diabetes. The prevalence rate was as high as 42.1% and 18.8% respectively. The mortality rate of patients with basic diseases was significantly higher than that of those without basic disease (x2=8.726, P=0.013). The proportion of patients with the history of live bird exposure before the onset was larger, especially those with the live bird market exposure history, which accounted for ILI cases from 64.7%.2.2013 to 2015. 6 cases of H7 positive patients were detected by the Chinese Communist Party. The positive rate of H7 was about 12/10 million. 3 cases of H7 positive patients were monitored in SARI cases. The positive rate of H7 was about 60/10 million.ILI and SARI cases, and there was no statistically significant difference in the positive rate of H7 in 3 years (x2=2.091, P=0.343, etc.). The positive rates of H7 in different ages were different (x2=12.334, P=0.001, x2=20.310, P0.001). As the age increased, the positive rate of H7 in ILI cases was also higher (x2=14.343, P=0.001). In SARI cases, the positive rate of 40~ age and age group was higher than that of low age group, and 28 cases of positive patients were positive. The rate of output was 0.8%, GMT was 1:5.2, and 32 cases of H7 were positive in 1559 cases of wading birds, the positive rate was 2.1%. The positive rate of antibody positive rate in 1:6.8. community healthy population and occupational exposure population was statistically significant (x2=14.646, P0.001), and the level of antibody titer in occupational exposure population was significantly higher. Conclusion: 1. middle aged men and aged men, Huan Youji Patients with basic diseases, urban residents, farmers or retirees and patients with a history of live poultry exposure before the onset of the disease have a greater proportion. The mortality rate of middle-aged and elderly people with basic diseases is high. The proportion of patients with self-raised poultry exposure and basic diseases in rural areas, which are gradually rising, are rarely monitored in.2.ILI and SARI cases. The positive rate of H7 in SARI cases was higher than that in ILI cases, the positive rate of H7 in.3. was 0.8%, the positive rate of H7 positive in occupational exposure population was 2.1%, and the positive rate of H7 antibody in occupational exposure population was higher than that of the community healthy population.
【学位授予单位】：宁波大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R511.7

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