淄博市甲型H1N1流感感染状况调查研究

发布时间：2018-06-20 14:05

本文选题：甲型H1N1流感 + 抗体　；参考：《山东大学》2011年硕士论文

【摘要】：研究背景 2009年甲型H1N1流感在我国广泛传播,由于甲型H1N1流感患者临床表现缺乏特异性,只能通过核酸检测和病毒分离确诊,检测费用成本高,不能广泛应用于临床诊断,同时由于大量轻症患者和隐性感染的存在,通过疾病监测信息系统报告的确诊病例数不能反映疫情的实际情况,因此需要了解不同时间节点我国各年龄段人群的实际感染水平,为完善疫情防控措施和应对流感大流行提供可靠的科学依据。2009年底国家制定调查方案在全国范围内开展甲型H1N1流感感染状况调查。根据方案要求,淄博市被抽取为山东省项目调查市。研究目的该次调查目的主要是掌握不同时期、不同地区、不同人群甲型H1N1流感感染水平；了解淄博市甲型H1N1流感病毒感染情况的动态变化趋势,为应对流感大流行,完善疫情防控措施提供科学依据。资料与方法采取多阶段分层随机抽样方法,从淄博市9个区县中随机抽取2个区县作为本次项目调查区县,每个区县随机抽取2～5个街道办事处,每个街道办事处再随机抽取3～5个居委会。分别于2010年1月、2010年3～4月、2010年8～9月开展三次横断面调查。每次调查,每个区县按照0～5岁,6～15岁,16～24岁,25～59岁,60岁及以上5个年龄组抽取调查对象,每个年龄组在150人左右,三次横断面调查共抽取调查对象4500人。对所有确定的调查对象进行问卷调查,并采集静脉血分离血清进行甲型H1N1流感血凝抑制试验,血凝抑制抗体效价≥1：40为阳性,所有调查问卷双录入Epidata 3.1数据库并进行一致性检验。数据运用SPSS 13.0软件进行统计分析,率的比较采用χ2检验。主要结果 1、4500名调查对象中,甲型H1N1流感病毒抗体阳性率25.60%,自然感染率21.09%,显性感染和隐性感染比例为1.97：1。男性阳性率为27.05%,稍高于女性24.39%,不同地区间差异无统计学意义。 2、4500人中共有476人接种了甲型H1N1流感疫苗,占调查人数的10.58%,接种甲流疫苗者抗体阳性率42.65%,高于未接种甲流疫苗抗体阳性率23.58%。 3、全人群、接种甲型H1N1流感疫苗者和未接种甲型H1N1流感疫苗者抗体阳性率均以第一次调查为最高。接种甲流感疫苗1个月之内抗体呈上升趋势,15～28天抗体阳性率最高71.43%,以后随时间推移抗体衰减,接种半年后抗体阳性率11.36%。 4、全人群甲型H1N1流感阳性率以16～24年龄组为最高33.99%,60岁以上年龄组最低14.43%。 5、全人群甲型H1N1流感阳性率以教师为最高,38.10%,学生次之,35.68%,医务人员阳性率相对较低,19.35%。 6、至少接种1剂流感疫苗者甲型H1N1流感阳性率33.97%,高于自2007年以来未接种过流感疫苗者抗体阳性率22.54%。 7、甲型H1N1流感感染者中,发烧者占61.23%,有咳嗽症状者占69.70%,有咽痛症状者占54.80%,全部症状具备者所占比25.88%,感染者均为轻症病例。结论与建议 1、本次调查淄博市甲型H1N1流感抗体阳性率25.60%,与全国人群甲型H1N1流感病毒平均抗体阳性率一致,不同地区人群甲型H1N1流感的易感性和感染风险是一致的。2009年甲型H1N1流感在淄博市广泛传播,自然感染率为21.09%,实际感染人数远远超过确诊病例数。 2、甲型H1N1流感流行病学特征与季节性流感相似,一是学龄人群和年轻人群是最大的感染群体；二是在感染人群里,有一定比例的人是没有出现流感样症状的。 3、接种甲型H1N1流感疫苗具有良好的流行病学保护效果,接种季节性流感疫苗可能对甲型H1N1流感具有一定的交叉保护作用,特定人群中季节性H1N1流感抗体可能对甲型H1N1流感有一定程度的保护作用。 4、随时间推移全人群、接种甲型H1N1流感疫苗者和未接种甲型H1N1流感疫苗者抗体阳性率均呈逐渐下降趋势,以接种疫苗者抗体水平下降速率较快。 5、接种流感、甲型H1N流感疫苗可以产生针对性的抗体,提高人群免疫水平,由于随着免疫后的时间推移,抗体水平有下降趋势,建议重点人群每年接种流感疫苗。 6、扩大流感监测范围,长期、连续地开展流感监测,以便于及时、准确地掌握流感活动情况,为季节性流感流行、流感大流行预警提供可靠依据。 7、定期在人群中开展流感病毒抗体监测,可以了解人群对流感流行株的免疫保护和病毒抗原变化,为防控流感提供重要依据。
[Abstract]:Research background
Influenza A (H1N1) influenza was widely spread in China in 2009. Due to the lack of specificity in clinical manifestations of influenza A (H1N1) patients, it can only be diagnosed by nucleic acid detection and virus isolation, and the cost of detection is high. It can not be widely used in clinical diagnosis. At the same time, the disease monitoring information system has been reported for the presence of a large number of patients with mild disease and latent infection. The number of confirmed cases does not reflect the actual situation of the epidemic. Therefore, it is necessary to understand the actual infection level of the people of all ages in China at different time, and to provide a reliable scientific basis for improving the prevention and control measures and responding to the influenza pandemic in China at the end of.2009. According to the requirements of the plan, Zibo was selected as an investigation city of Shandong province.
research objective
The purpose of this survey is to grasp the level of influenza A (H1N1) infection in different periods, different regions and different populations, to understand the dynamic trend of influenza A (H1N1) virus infection in Zibo, and to provide a scientific basis for dealing with influenza pandemic and improving the prevention and control measures of the epidemic.
Information and methods
By multistage stratified random sampling, 2 districts and counties were randomly selected from 9 districts and counties in Zibo. 2~5 Street offices were randomly selected from each district and county, and 3~5 neighborhood committees were randomly selected from each street office. Three cross-sectional investigations were carried out in January 2010, 2010, 3~4 and 8~9 2010. Each district and county selected the subjects according to the 5 age groups of 0~5, 6~15, 16~24, 25~59, 60 and above, each age group of about 150 people, and three cross-sectional survey of 4500 people in each survey.
All the selected subjects were investigated by questionnaire, and the blood serum was collected for H1N1 influenza A hemagglutination inhibition test. The titer of the hemagglutination inhibition antibody was more than 1:40 as positive. All the questionnaires were recorded in the Epidata 3.1 database and tested the consistency.
Data were analyzed by SPSS 13 software, and chi square test was used to compare the rates of data. 2.
Main results
Among the 14500 subjects, the positive rate of H1N1 influenza A virus was 25.60%, the natural infection rate was 21.09%, the positive rate of dominant infection and recessive infection was 27.05%, which was slightly higher than that of female 24.39%. There was no statistical difference between different regions.
A total of 476 people were vaccinated with H1N1 influenza A (H1N1) vaccine, accounting for 10.58% of the number of people surveyed. The positive rate of antibody to the vaccine was 42.65%, which was higher than that of non immunization of 23.58%. vaccine.
3, the whole population, the positive rate of the antibody positive of the H1N1 influenza A vaccine and the uninoculated H1N1 influenza vaccine was the highest. The antibody showed an upward trend within 1 months and the positive rate of the 15~28 day antibody was 71.43%. The antibody attenuated with time and the antibody positive rate was 11.36%. after half a year.
4, the positive rate of influenza A (H1N1) in the whole population was the highest 33.99% in the 16~24 age group, and the lowest in the age group 60 and above 14.43%.
5, the positive rate of influenza A (H1N1) in the whole population was the highest among teachers, 38.10% of students, 35.68% of the students, and the positive rate of medical staff was relatively low, 19.35%.
6, the positive rate of influenza A (H1N1) is 33.97% at least 1 doses of influenza vaccine, which is higher than that of those who have not been vaccinated since 2007. The positive rate is 22.54%.
7, among those infected with influenza A (H1N1), 61.23% were fever, 69.70% with cough symptoms, 54.80% with sore throat symptoms, 25.88% of all patients with symptoms, and all cases were light cases.
Conclusions and suggestions
1, the positive rate of influenza A influenza A (H1N1) antibody in Zibo was 25.60%, which was the same as the positive rate of H1N1 influenza A virus in the whole country. The susceptibility and risk of influenza A (H1N1) influenza in different regions were consistent with the.2009 influenza A (H1N1) influenza in the city of Zibo. The natural infection rate was 21.09%, and the actual infection number was far away from the population. More than the number of confirmed cases.
2, the epidemiological characteristics of influenza A (H1N1) influenza are similar to those of seasonal influenza. One is that the school age group and the young people are the largest infected group; and the two is that in the infected people, there is a certain proportion of people who have no flu like symptoms.
3, inoculation of influenza A (H1N1) influenza vaccine has a good epidemiological protection effect. Inoculation of seasonal influenza vaccine may have a certain cross protective effect on H1N1 influenza A. The seasonal H1N1 influenza antibody in a specific population may have a certain degree of protection for a influenza A (H1N1) influenza.
4, in the whole population over time, the positive rate of antibody positive of influenza a H1N1 vaccine and non a H1N1 influenza vaccine declined gradually, and the antibody level of the vaccinated people decreased rapidly.
5, inoculation of influenza A influenza A (H1N) vaccine can produce specific antibodies to improve the immune level of the population. As the time goes on, the level of antibody decreases, and it is suggested that the key population be vaccinated every year.
6, to expand the monitoring range of influenza and to carry out continuous monitoring of influenza for a long time, so as to facilitate the timely and accurate control of influenza activity, and provide a reliable basis for the epidemic of seasonal influenza and the early warning of influenza pandemic.
7, to monitor influenza virus antibody regularly in the population, we can understand the immune protection and change of virus antigen of influenza epidemic strains, and provide important basis for preventing and controlling influenza.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R181.3

【参考文献】