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目的通过了解现阶段北京市平谷区高危人群布鲁菌病(简称布病)流行特征、临床特点和感染的危险因素,以指导预防控制工作。方法对感染者和未感染者进行现场问卷调查、采样、实验室检测;对检测、调查数据汇总;采用Epi Data3.0软件建立数据库;采用描述性研究方法对调查对象进行流行特征、临床特点的分析,同时对资料完整的高危人群实验室检测阳性33例感染者和557例阴性未感染者进行危险因素分析。结果 2007—2013年平谷区布病感染共41例,以农村男性养殖业为主、好发于春(1—3月份)秋(8—10月份)季;临床表现典型、病情较重,部分病例表现出布病特有的临床症状为睾丸肿大,24.32%的患者需要住院治疗,住院治疗的全部为农民。Logistic回归分析发现挤奶(OR=27.701,95%CI=1.825~420.452)、接羔(OR=5.806,95%CI=1.611~20.919)、共同饮用同一水源(OR=14.576,95%CI=1.019~52.865)、生熟案板不分开(OR=14.676,95%CI=1.336~49.672)、其他接触方式(OR=8.788,95%CI=1.925~10.130)(接触死羊、羊的流产物、牛羊粪便)与布病感染存在独立的关联。挤奶、接羔、共同饮用同一水源、生熟案板不分开、接触死羊、羊的流产物、牛羊粪便是布病感染的影响因素。结论平谷区应在春秋季节重点加强对农村男性布病知识宣传和基层医务人员的培训。应针对其危险因素有针对性地进行干预。
Objective To understand the epidemiological characteristics, clinical features and risk factors of brucellosis in high-risk population in Pinggu District of Beijing at this stage to guide prevention and control. Methods A questionnaire survey, sampling and laboratory tests were conducted on infected and uninfected people; the testing and investigation data were summarized; Epi Data3.0 software was used to establish the database; the descriptive research method was used to carry out epidemiological and clinical characteristics of the surveyed patients At the same time, we analyzed the risk factors of 33 laboratory positive patients with positive data and 557 negative non-infected patients with positive data. Results A total of 41 cases of brucellosis were reported in Pinggu District from 2007 to 2013, mainly in rural male breeding industry, which occurred in the autumn (January-March) autumn (August-October) season. The clinical manifestations were typical and the condition was severe. Cases showed brucellosis specific clinical symptoms of testicular swelling, 24.32% of patients need hospitalization, hospitalization for all farmers. Logistic regression analysis showed that milking (OR = 27.701, 95% CI = 1.825-420.452) and lambing (OR = 5.806, 95% CI 1.611-20.919) (OR = 14.676, 95% CI = 1.336-49.672), other exposure methods (OR = 8.788, 95% CI = 1.925-10.130) Sheep feces) and brucellosis infection exist independent association. Milking, then lamb, common drinking the same water, raw and cooked the board is not separated, contact dead sheep, sheep products, cattle and sheep manure is the impact of brucellosis infection. Conclusion Pinggu District should focus on strengthening the publicity of brucellosis among rural men and the training of grassroots medical personnel in the spring and autumn. The risk factors should be targeted for intervention.