Logistic回归模型拟合SABS发病及流行特征

目的 利用比Logistic回归模型预测SARS发病及流行趋势，研究SARS发病与流行特征及相应预防措施对疾病流行的影响，为预防与控制SARS提供科学依据。方法 使用Logistic回归模型拟合广东省、香港特别行政区、北京市及山西省累计发病数据，并绘制出SARS流行曲线。结果 对上述地区发病人数进行拟合，各地曲线拟合的决定系数R2均大于0.99，预测值与实际值符合，无显著性差异。从SARS流行曲线推算出各地发病高峰及时间分布，预防措施对疾病流行曲线有明显影响。结论 Logistic回归模型对SARS流行的拟合效果好，可用于理论上探讨预防措施对SARS发病及流行特征的研究。     

卫生统计

时间序列分析简明攻略；确切Logistic回归方法及其医学遗传学应用；相关分析在建立基因调控网络中的应用；证实性因子分析在量表等价性评价中的应用研究；Logistic回归模型拟合SARS发病及流行特征；广东省SARS疫情发展的分段室模型分析；SIR型传染病模糊控制模型及其应用；     

SIR模型对北京市SARS疫情流行规律的拟合研究

目的　探讨SARS在人群中的传播规律 ,研究预防措施对疾病传播的影响 ,为预防的控制SARS提供科学依据。方法　根据北京市SARS原始数据和易感者、传染者及消除者 (SIR)模型方程组 ,计算出易感者、传染者及消除者人数 ,并求出传染率、消除比及阈值等具有流行病学意义的参数。结果　对上述三类人群数量进行拟合 ,预测值与实际值相符合 ,差异无显著性。估计 4月2 1日的易感者 (密切接触者和一般接触者 )人数为 81 4 70人 ,传染率r为 4 .0 31× 1 0 -5,消除比γ为 3.1 5 0 ,阈值 ρ为 781 4 5。 结论　SIR回归模型对SARS传播的拟合效果好 ,可用于理论上探讨预防措施对SARS发病及传播规律影响的研究。 4月 2 1日后采取的预防措施及时有效 ,防止了疫情进一步蔓延     

广东省SARS传播模型实证研究

目的探讨严重急性呼吸系统综合征(severe acute respiratory syndrome,SARS)在人群中的传播规律,研究预防措施对疾病的影响,为预防控制SARS提供科学依据。方法用确定性的SIR模型和SEIDR模型等传播动力学数学模型对SARS流行过程进行估计与分析。结果通过对卫生部2003年4月22日公布的广东省的数据,用确定性SIR模型估计消除比。广州市SARS的基本繁殖率为3.5左右。结论确定性的SIR模型、确定性SEIDR模型能比较好模拟并估计出SARS传播过程,并能够对未来的SARS流行趋势和流行规模进行预测。     

气压与气温对SARS发病流行的影响分析

目的 分析SARS发病率与气压、气温的关系，探讨影响SARS发病流行的自然环境因素。方法 应用描述流行病学、相关与回归分析方法研究广州和香港SARS发病率与当地平均气压、平均气温的相关和多元线性回归关系。结果 广州和香港SARS暴发期与消退期相比，平均气压分别高5．5hPa和6．2hPa，平均气温分别低4．3℃和6．0℃。SARS发病率与平均气压成正相关，与平均气温成负相关，多元线性回归分析结果表明，SARS发病与气压气温的回归关系有显性差异。结论 SARS的发病流行受气压、气温等自然环境因素的影响。     

肝衰竭预后影响因素的Logistic回归分析

目的 探讨影响肝衰竭预后的因素,拟合回归方程用于肝衰竭预后的判断.方法 回顾性收集肝衰竭患者的临床资料,采用二元Logistic回归法对可能影响肝衰竭预后的因素进行分析并建立回归模型,绘制ROC曲线,确定预后模型的最佳临界值.结果 单因素Logistic回归分析显示,甲胎蛋白、血清总胆固醇升高为肝衰竭预后的保护因素;高龄,总胆红素(total bilirubin,TBIL)、国际标准化比值、尿素氮升高和肝性脑病、上消化道出血、腹水为肝衰竭预后的危险因素.经多因素Logistic回归分析筛选出年龄(OR1=7.207,OR2=21.251,P＜0.001)、血清TBIL(OR=0.347,P=0.002)、总胆固醇(OR=3.769,P＜0.001)、腹水(OR=0.142,P=0.002)4个因素用于回归模型的拟合.ROC曲线下面积为0.893,模型预测准确率为86.96％.结论 研究中拟合的回归方程预测准确率较高,对肝衰竭预后的判断有一定参考价值.     

妊娠期糖尿病孕妇早期筛查模型的建立及应用价值

目的 研究妊娠期糖尿病(GDM)孕妇早期筛查模型的建立及应用价值.方法 纳入2015年7月-2019年7月湖州市妇幼保健院收治的468例孕妇为研究对象,开展回顾性分析.统计患者一般资料,分析GDM发生情况,采用多因素Logistic回归分析法分析GDM发病的独立影响因素,并建立GDM早期筛查模型,采用受试者工作特征曲线...     

BP神经网络在代谢综合征影响因素分析中的应用

目的探讨BP神经网络筛选疾病相关因素及构建疾病预测模型的作用,并与Logistic回归模型的分析结果进行对比,为更加准确地运用神经网络方法解决医学实际问题提供科学依据。方法利用MATLAB软件中的神经网络工具箱,建立代谢综合征相关影响因素的BP神经网络模型,通过计算平均影响值对影响因素进行筛选,依据ROC曲线下面积对比BP神经网络与Logistic回归分析所构建的疾病预测模型的效果。结果利用BP神经网络所构建的疾病预测模型,通过平均影响值算法筛选变量后的预测效果要好于未筛选的效果,且通过平均影响值算法所筛选的影响因素与Logistic回归分析基本一致,两者预测效果差异无统计学意义（AUCBP=0.837,AUCLogistic=0.841,u=0.3310,P=0.7406）。结论运用BP神经网络的平均影响值算法可实现对疾病相关因素的筛选及构建疾病预测模型,可在流行病学病因探索的研究中发挥与Logistic回归分析同样的作用。     

中位数回归模型及自回归模型在北京市SARS发病预测中的应用

目的探讨北京SARS发病的动态变化规律.方法建立北京市SARS发病长期预测的中位数回归模型以及短期预测的自回归模型.结果以4月24日～5月11日的数据建模,对SARS进行长期预测的中位数回归模型为:Yi0.5=129.2-4.7ti,预测其新增临床诊断病例数将于5月22日降至零病例;同时考虑时间(ti)、前一天的新增临床疑似病例数(Zi-1),对SARS进行短期预测的二阶自回归模型(第一步)为:Yi=79.9526-0.2773Yi-1 0.3582Yi-2 0.2848Zi-1-2.8175ti.预测其新增临床诊断病例数将于5月21日降至零病例.结论SARS发病长期预测用中位数回归较一般线性回归稳健;SARS发病短期预测的自回归模型取二阶较适宜.长期预测与短期预测中新增临床诊断病例数降至零病例的时间基本一致.在传染病的发病预测中使用中位数回归模型及自回归模型的方法具有广阔的应用前景.     

广义线性混合模型在煤工尘肺发病影响因素研究中的应用

目的研究广义线性混合模型在煤工尘肺发病影响因素的应用,为煤工尘肺及类似疾病的发病影响因素研究提供新的方法。方法收集煤矿集团所属8个煤矿所有接尘矿工的资料,用SAS进行卡方检验、Logistic回归进行尘肺发病影响因素研究,并与SAS nlmixed模块实现的广义混合现行模型结果进行比较。结果单因素分析、Logistic回归和广义线性混合模型显示:工龄、接尘时间和工种均为尘肺发病的影响因素,工作地点作为随机效应结果差异无统计学意义。结论广义线性混合模型因考虑了不同工人工作地点的不同和随机效应,结果虽然和其他方法一致,但是更有说服力,与其他方法相比是研究尘肺发病影响因素较好的方法。     

深圳市抗击"非典"实施策略及效果分析

目的 分析深圳市SARS流行控制应急实施策略及其效果，揭示深圳防控SARS的成效与经验。方法 收集深圳市SARS预防控制及治疗等有关资料，进行流行病学和社会医学分析。结果 深圳市防治非典成效显，发病率(0．76／10万)、病死率低(1．8％)、治愈率高(86．9％)，医务人员零感染；快速建立启动应急机制，科学判断，果断决策，快速隔离病人筛选有效救治方案，医务人员预防服药，开展全民健康教育可以有效控制疫情蔓延。结论 深圳市控制SARS是成功的，为今后应对突发公共卫生事件提供了经验。     

高校严重急性呼吸综合征监测系统和控制措施效果评价

目的 对高校严重急性呼吸综合征(SARS)的监测系统和控制措施效果进行评价。方法 收集某高校在广州市SAPS流行期间疫情发生情况与紧急应对的组织领导、防治策略和控制措施效果。结果 在SAPS流行期间高校建立“个人-宿舍(家庭)-班级(单位)-系-院-学校”的监测系统,采取针对性的预防控制措施,切实做到“早发现、早诊断、早隔离、早预防及早治疗”,贯彻“早、小、严、实”的疫区处理原则,实现少发生、无续发、不流行、无死亡及稳定校园教学秩序的目标。结论 严密的监测系统和以早期隔离患者与密切接触者为主的综合防治措施,能够有效地控制SAPS在高校流行。     

Factors influencing the wearing of facemasks to prevent the severe acute respiratory syndrome among adult Chinese in Hong Kong

BACKGROUND: The global outbreak of the severe acute respiratory syndrome (SARS) in 2003 has been an international public health threat. Quick diagnostic tests and specific treatments for SARS are not yet available; thus, prevention is of paramount importance to contain its global spread. This study aimed to determine factors associating with individuals' practice of the target SARS preventive behavior (facemask wearing). METHODS: A total of 1329 adult Chinese residing in Hong Kong were surveyed. The survey instrument included demographic data, measures on the five components of the Health Belief Model, and the practice of the target SARS preventive behavior. Logistic regression analyses were conducted to determine rates and predictors of facemask wearing. RESULTS: Overall, 61.2% of the respondents reported consistent use of facemasks to prevent SARS. Women, the 50-59 age group, and married respondents were more likely to wear facemasks. Three of the five components of the Health Belief Model, namely, perceived susceptibility, cues to action, and perceived benefits, were significant predictors of facemask-wearing even after considering effects of demographic characteristics. CONCLUSIONS: The Health Belief Model is useful in identifying determinants of facemask wearing. Findings have significant implications in enhancing the effectiveness of SARS prevention programs.     

山东省6县（区）部分人群预防SARS行为调查分析

目的了解山东省不同地域居民SARS流行期生活行为及流行前后行为变化情况。方法选择城市和乡镇社区对于SARS传播和控制意义较重要的具有代表性的7个人群进行入户式现场调查。结果人们从个人卫生、公共卫生、提高身体素质、减少接触机会、维护生态平衡等多个方面约束或改进了个人行为。92.0%的被调查者认为非典流行促使自己改进了生活习惯。结论山东省人群非典期间采取预防行为的比率很高,为今后SARS、禽流感及其他呼吸道传染病的预防奠定了良好的基础。     

The Singaporean response to the SARS outbreak: knowledge sufficiency versus public trust

During the outbreak of severe acute respiratory syndrome (SARS) in Singapore from 1 March to 11 May 2003, various national prevention and control measures were undertaken to control and eliminate the transmission of the infection. During the initial period of the epidemic, public communication was effected through press releases and media coverage of the epidemic. About a month into the epidemic, a public education campaign was mounted to educate Singaporeans on SARS and adoption of appropriate behaviours to prevent the spread of the disease. A survey was conducted in late April 2003 to assess Singaporeans' knowledge about SARS and infection control measures, and their concerns and anxiety in relation to the outbreak. The survey also sought to assess their confidence in the ability of various institutions to deal with SARS and their opinion on the seemingly tough measures enforced. The study involved 853 adults selected from a telephone-sampling frame. Stratified sampling was used to ensure adequate representation from major ethnic groups and age groups. The study showed that the overall knowledge about SARS and control measures undertaken was low (mean per cent score of 24.5 +/- 8.9%). While 82% of respondents expressed confidence in measures undertaken by Tan Tock Seng Hospital (the hospital designated to manage SARS), only 36% had confidence in nursing homes. However, >80% of the public agreed that the preventive and control measures instituted were appropriate. Despite the low knowledge score, the overall mean satisfaction score of the government's response to SARS was 4.47 (out of possible highest score of 5.00), with >93% of adult Singaporeans indicating that they were satisfied or very satisfied with the government's response to SARS. Generally, Singaporeans had a high level of public trust (satisfaction with government, confidence in institutions, deeming government measures appropriate), scoring 11.4 out of possible maximum of 14. The disparity between low knowledge on the one hand and high confidence and trust in the actions of the government on the other suggests that Singaporeans do not require high knowledge sufficiency to be confident in measures undertaken by the government to control the SARS crisis.     

SARS related preventive and risk behaviours practised by Hong Kong-mainland China cross border travellers during the outbreak of the SARS epidemic in Hong Kong

OBJECTIVES: To investigate patterns of behaviours and attitudes related to SARS prevention in the Hong Kong cross border traveller population.Settings: A survey was carried out at the Hong Kong-China cross border checkpoint in the middle of the epidemic. PARTICIPANTS: A total of 839 Hong Kong adult residents returning to Hong Kong from mainland China were surveyed. MAIN OUTCOME MEASURES: Practice of preventive measures and relevant behaviours and attitudes. RESULTS: Around 40% of the respondents were using masks all or most of the time in public places or washing their hands frequently (>10 times per day) and about one third avoided visiting crowded places in mainland China. Such figures were however lower than those practised by the general public in Hong Kong. SARS related perceptions, such as perceived risk of transmission and efficacy, etc, were associated with mask use and not visiting crowded places, but not with hand washing, which was associated with duration of stay. Gender differences were also observed. Around 70% of the travellers would have delayed medical consultation for influenza-like illness in China; 12.7% would not wear masks during such episodes of illness. Furthermore, about 30% of the respondents used to wear masks in Hong Kong but not in mainland China. CONCLUSIONS: The findings have implications on cross border prevention of SARS. It seems that those travelling during the SARS epidemic were a "self selected" group, and they were using less preventive measures. Special attention and intervention need to be provided to travellers to prevent a second wave cross border transmission of the disease.     

我国突发公共卫生事件SARS与COVID - 19的应急处置比较和再认识

目的 通过对SARS和COVID - 19应急处置核心要素的分析和再认识,为防控疫情、规范突发公共卫生应急处置体系提出建议。方法 收集SARS和COVID - 19应急处置过程中涉及的卫生措施和文献政策并进行分析。结果 两次疫情在应急处置方面存在差别,相比于2003年的SARS,新冠疫情在危机预警、政府指挥、信息发布和疫情恢复重建等核心要素已得到良好的改善和发展。结论 我国的应急处置工作已经取得较大进步;国家还应积极采取相应措施完善应急预警、加强疫情宣讲等,以期为防治COVID-19或其他重大传染病提供策略建议,对完善我国突发公共卫生事件应急处置体制提供参考。     

快速优质高标准防治SARS

在SARS疫情严重的情况下，军区部队认真贯彻党中央、中央军委和总部首长的指示精神，抓早、抓细、抓实、抓严，高标准地做好了SARS防治工作，取得了阶段性胜利。主要做法：健全防治组织，始终保持强有力的领导；强化防疫措施，严控“三个环节”；狠抓部队管理，严防输入性传染；快速筹措药品器材，确保各项措施到位；加强医疗单位自身防护，确保医务人员无一感染发病；抓好检查指导，工作持之以恒。主要体会：必须充分动员各方面的力量，形成工作的整体合力；必须实行快速反应，正确指挥；必须从严从细落实各项防疫措施；必须有“打持久战”的思想准备；必须在防治措施上不断创新。     

Which preventive measures might protect health care workers from SARS?

Background  

Despite the use of a series of preventive measures, a high incidence of severe acute respiratory syndrome (SARS) was observed among health care workers (HCWs) during the SARS epidemic. This study aimed to determine which preventive measures may have been effective in protecting HCWs from infection, and which were not effective.     

天津市传染性非典型肺炎流行特点及主要控制措施效果评价

目的：分析天津市传染性非典型肺炎[严重急性呼吸综合征(SARS)]流行病学特征，对主要控制措施的效果进行初步评价。方法：采用自行设计的病例报告表，全市统一的流行病学个案调查表及病例接触者、密切接触者树状分布图，深入病房、家庭、社区、团体等对病例及接触者进行调查。结果：以发病时间计算，自2003年4月13日至5月8日，包括输入病例在内发病175例，发病率为1．9／10万，其中死亡14例，病死率达8．O％。整个流行过程不足1个月，流行特点：1例“超级传播者”直接或间接传染了全市94．3％的病例；呈现以A、B、C 3家医院聚集发病为特点的爆发性流行，占全市病例的68．6％，3家医院外的家庭聚集发病占全市病例的14．3％，同事间传播为2．3％，散发者为9．1％，这些散发者未造成接触者感染；早期医务人员发病较多，占总病例数的38．2％，流行全过程参加SARS救治工作的1975名医护人员的总感染率为3．4％；全部流行过程传染源明确，传染链清晰，全市仅3例患者未找到传染源，占病例总数的2％；在10例源头病例中仅“超级传播者”和另一病例传染了其接触者，其他传染源由于及时隔离未造成任何传播。结论：SARS是严重急性呼吸系统传染病，如能及时准确地掌握传染链并进行范围适当、及时有效的封闭及隔离措施，以科学的方法提高全民的警觉度，传染链可能在较短时间内被切断，从而控制传播。