张家界市2008-2012年手足口病流行病学研究

发布时间：2018-03-23 14:39

本文选题：手足口病　切入点：流行病学特征　出处：《中南大学》2013年硕士论文

【摘要】：目的：1.了解张家界市2008-2012年手足口病发病情况；2.分析手足口病时间、地区、人群三间分布及病原学构成特征；3.分析张家界市手足口病重症病例的临床表现特征；4.为制定张家界手足口病防控策略提出针对性建议。方法：进入国家疾病监测信息系统,按现住地址、发病日期导出2008-2012年的张家界市手足口病病例资料,对张家界市手足口病发病率、死亡率及流行病学分布特征进行统计分析。对所有重症和死亡病例进行用《手足口病预防控制指南》(2009版)的调查表进行流行病学调查,对其发病的临床特征进行分析。同时收集市疾控中心实验室对各区县送检的部分手足口病患者粪便、咽拭子标本的检测结果,分析张家界市手足口病的病原学特征。结果：1.2008至2012年张家界市共报告手足口病例4975例,其中重症病例19例(包括死亡病例4例)。分年度发病数分别为154例、177例、1501例、490例、2653例；分年度发病率分别为：10.33/10万、11.85/10万、100.27/10万、33.19/10万、178.72/10万。4975例手足口病例中临床诊断4716例,占94.79%；实验室确诊259例,占5.21%。 2.张家界市手足口病患者的发病年龄主要为1-4岁婴幼儿。2008至2012年1-4岁婴幼儿分别占该年HFMD报告病例数的79.87%、81.92%、79.95%、78.98%、75.31%。男性发病多于女性,2008至2012年手足口病男女发病数相对比最高2.4：1,最低1.73：1。病例类型以散居儿童(76.98%)为主,其次为托幼儿童(19.30%)；聚集疫情76.19%发生在散居儿童。 3.各月均有病例报告,但每年春夏之间的4-7月及冬季11月为发病高峰,2008-2012年4-7月手足口病发病人数占当年手足口病例总数的比例分别为25.32%、51.41%、49.83%、39.80%、62.53%；辖区内四个区县均有手足口病例报告,以两区(永定区、武陵源区)为高发地区。 4.张家界市手足口病病原谱以EV71为主,占阳性标本的52.83%,是引起张家界市手足口病暴发流行的主要病原体。2010-2012年病原体为EV71的手足口病病例占本年实验室检测病例数的比例分别为30.77%、48.72%、84.34%。 5.手足口病重症病例的主要神经系统症状为精神差、烦躁不安、易惊、头痛、嗜睡、抽搐、手足抖动等；主要呼吸系统症状为呼吸急促、呼吸困难、口唇紫绀、咽痛、咳嗽等；主要循环系统症状为心率加快、心跳节律改变、皮肤颜色异常、指、趾或口唇发绀等。结论：2008至2012年张家界市累计报告手足口病例4975例,其中重症病例19例,死亡4例；病例以1-4岁低年龄组儿童为主,病例类型主要为散发儿童,以每年4-7月和11月为高发期,以永定区和武陵源区为高发地区；EV71是导致张家界市手足口病发生及重症的主要病原体；手足口病重症病例的主要临床表现为头痛、精神差、易惊、呼吸急促、呼吸困难、心率加快、心跳节律改变等。
[Abstract]:Objective to understand the incidence of hand-foot-mouth disease in Zhangjiajie from 2008 to 2012. To analyze the time and area of hand-foot-mouth disease, Analysis of the clinical manifestations of severe hand-foot-mouth disease cases in Zhangjiajie City. 4. Suggestions for formulating prevention and control strategies of hand-foot-mouth disease in Zhangjiajie. Methods: the data of hand, foot and mouth disease cases in Zhangjiajie City from 2008 to 2012 were derived according to the current address and date of onset, and the incidence of hand foot and mouth disease in Zhangjiajie City was analyzed. The mortality and epidemiological distribution characteristics were statistically analyzed. All severe and fatal cases were investigated with the questionnaire of the guidelines for the Prevention and Control of hand, foot and mouth Disease (2009 edition). The clinical characteristics of the disease were analyzed, and the results of feces and throat swabs of some hand-foot-mouth disease patients were collected in the laboratory of the Center for Disease Control and Prevention, and the etiological characteristics of hand-foot-mouth disease in Zhangjiajie were analyzed. Results 1. From 2008 to 2012, 4975 cases of hand, foot and mouth disease were reported in Zhangjiajie, including 19 cases of severe disease (including 4 cases of death). The annual incidence of HFMD was 100.27 / 100.27 / 100.27 / 100.27 / 100.27 / 100.75 cases of hand-foot-mouth disease, respectively: 4716 cases (94.79%) were clinically diagnosed, and 259 cases (5.21%) were confirmed in the laboratory, out of 178.72% .4975 cases of hand, foot and mouth disease. 2. The onset age of HFMD patients in Zhangjiajie City is mainly 1-4 years old infants and infants aged 1-4 years. From 2008 to 2012, infants aged 1-4 years accounted for 79.87% of the reported cases of HFMD in that year, respectively. 79.959.95% 78.98% of the total incidence of HFMD patients was 75.31%. The incidence of hand-foot-mouth disease in men was higher than that in women from 2008 to 2012. The incidence of hand-foot-mouth disease in men was higher than that in women from 2008 to 2012. The highest is 2.4: 1, and the lowest is 1.73: 1.The type of case is mainly scattered children (76.98). The incidence of agglomeration was 76.19% among scattered children. 3. Cases of HFMD were reported every month, but the number of HFMD cases accounted for 25.32% of the total number of HFMD cases in that year between April to July 2008 and November of winter in November of winter were 25.32% of the total number of HFMD cases in that year, respectively. The proportion of HFMD cases reported in each of the four districts and counties in the jurisdiction was 62.53. Two districts (Yongding District, Wulingyuan District) for the high incidence area. 4. EV71 is the main pathogenic spectrum of hand-foot-mouth disease in Zhangjiajie city, accounting for 52.83% of positive specimens. It is the main pathogen causing HFMD outbreak in Zhangjiajie City. The proportion of HFMD cases with EV71 in 2010 to 2012 is 30.77 ~ 48.722% and 84.34% respectively. 5. The main nervous system symptoms of severe hand, foot and mouth disease cases were mental retardation, agitation, agitation, agitation, headache, drowsiness, convulsion, shaking of hand and foot, and the main respiratory system symptoms were shortness of breath, dyspnea, cyanosis of lips, sore throat, cough and so on. The main symptoms of circulatory system are heart rate acceleration, heart rhythm change, skin color abnormality, finger, toe or lip cyanosis, etc. Conclusion from 2008 to 2012, 4975 cases of hand-foot-mouth disease were reported in Zhangjiajie City, including 19 cases of severe disease and 4 cases of death. Taking Yongding District and Wulingyuan District as high incidence areas, EV71 is the main pathogen leading to the occurrence and severity of hand, foot and mouth disease in Zhangjiajie City, and the main clinical manifestations of severe cases of hand foot and mouth disease are headache, poor spirit, easy to panic, shortness of breath and difficulty in breathing. The heart rate quickens, the heartbeat rhythm changes, etc.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R181.3;R512.5

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