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目的探索影响合肥市个体流行性脑脊髓膜炎(流脑)发病的危险因素,了解A+C群脑膜炎球菌多糖疫苗(Meningococal Polssaccharide Vaccine,MPV)的保护率。方法选择2004年以来能联系到的100例流脑病人作为病例组,再根据病例组的城乡比例随机抽取若干户家庭电话,按1∶2比例选取与病例组年龄相匹配的健康人群作为对照组,电话调查影响个体流脑发病的危险因素及A+C群MPV的保护率。结果单因素分析显示:流动人口[比值比(Odds Ratio,OR)7.0,95%可信区间(Confidence Interval,CI)2.8~18]、经常感冒(OR5.2,95%CI2.5~11)、发病前感冒(OR14,95%CI5.0~37)、吸烟或被动吸烟(OR3.5,95%CI2.1~5.7)、既往气管炎等慢性病史(OR9.5,95%CI3.1~29)、经常出入公共场所(趋势χ2=20,P=0.000)是危险因素;接种C群MPV(OR0.20,95%CI0.11~0.39)、居室经常开门窗(OR0.05,95%CI0.01~0.37)、勤洗手(OR0.39,95%CI0.22~0.68)、接种A群MPV(趋势χ2=40,P=0.000)是保护因素。多因素分析显示:流动人口、接种A群MPV、洗手频次、经常感冒、发病前是否感冒、吸烟或被动吸烟、既往气管炎等慢性病史、接种A群与C群MPV的交互作用具有统计学意义。A+C群MPV的保护率(Protection Rate,PR)为84%。结论流动人口、经常感冒、发病前感冒、吸烟或被动吸烟、既往气管炎等慢性病史,是导致个体流脑发病的危险因素;接种A与C群MPV、勤洗手可降低流脑发病的危险性。其中未接种C群MPV且发病前感冒危险性最大。
Objective To explore the risk factors affecting the incidence of individual meningococcal meningitis in Hefei City and to understand the protection rate of meningococcal polysaccharide vaccine (Meningococal Polysaccharide Vaccine, A + C). Methods A total of 100 cases of meningitis patients who can be contacted since 2004 were selected as case groups. Then, a number of households were randomly selected according to the urban-rural ratio of case groups. A healthy population with a case-group age of 1: 2 was selected as the control group , Telephone survey of risk factors affecting the incidence of individual meningitis and A + C group MPV protection rate. Results Univariate analysis showed that the odds ratio (OR) was 7.0, 95% Confidence Interval (CI) 2.8-18), and the common cold (OR 5.2, 95% CI 2.5-11) , Cold before onset (OR14, 95% CI5.0 ~ 37), smoking or passive smoking (OR3.5,95% CI2.1 ~ 5.7), history of previous chronic bronchitis (OR9.5,95% CI3.1 ~ 29), frequent public access (trend χ2 = 20, P = 0.000) were risk factors; inoculation group C MPV (OR0.20,95% CI0.11 ~ 0.39), bedroom often open the door (OR0.05,95 % CI0.01 ~ 0.37), wash hands frequently (OR0.39,95% CI0.22 ~ 0.68), and inoculation group A MPV (trend χ2 = 40, P = 0.000) was the protective factor. Multivariate analysis showed that there was a significant difference in the interaction between inoculated group A and group C MPV in floating population, MPV in group A, frequent washings, frequent cold, cold before onset, smoking or passive smoking, previous history of bronchitis and other chronic diseases . The protection rate (PR) of A + C group MPV was 84%. Conclusions Floating population, frequent cold, pre-morbid cold, smoking or passive smoking, previous tracheitis and other chronic diseases are the risk factors leading to the onset of individual meningitis. Inoculating MPV with group A and group C may reduce the risk of developing meningococcal disease . Among them, C group MPV was not vaccinated and the risk of colitis was the highest before onset.