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目的调查一起不明原因凝血障碍聚集性病例事件,为采取针对性预防控制措施提供依据。方法依据统一的病例定义,应用流行病学方法,采集病例及密切接触者的血液、尿液标本,病家食材及周围环境有关标本,检测可疑致病因素。其中溴敌隆的检测应用液相色谱-质谱联用法(HPLC-MS/MS)。结果自2011年10月以来,某村局部范围内陆续出现不明原因出血性疾病患者,共涉及3户5例,病家相邻或相隔数户不等。5例病例和3例家属血样检测溴敌隆全部为阳性,5例病例邻居血样中1例检出溴敌隆阳性,并在病家食材中发现溴敌隆阳性标本,其他及周围环境样品溴敌隆检测阴性。结论事件是一起溴敌隆中毒引起的聚集性化学中毒事件。由村民食用被溴敌隆污染的食材(菜籽油)引起,不排除人为因素导致污染的可能性。
Objective To investigate a case of coagulation disorder with unknown causes and to provide a basis for taking targeted prevention and control measures. Methods According to the definition of a common case, epidemiological methods were used to collect blood and urine samples from patients and close contacts, and the relevant materials of the patients and the surrounding environment to detect the suspicious pathogenic factors. The detection of bromadiolone was applied to liquid chromatography-mass spectrometry (HPLC-MS / MS). Results Since October 2011, a group of 5 patients with 3 hereditary hemorrhagic diseases have been found in the local area of a village. The patients are adjacent or separated by a few households. In 5 cases and 3 relatives, the blood samples were all tested positive for bromadiolone, and 1 case of bromadiolone was detected in one of 5 cases of neighbor blood samples. Foul Long test negative. Conclusions The incident is an incident of aggregated chemical poisoning caused by bromadiolone poisoning. Caused by the consumption of ingredients contaminated by bromadiolone (rapeseed oil) by villagers, human factors do not rule out the possibility of contamination.