宁夏平罗县成人麻疹爆发的病例对照研究

目的探讨宁夏平罗县成人麻疹爆发的相关影响因素。方法采用1：2匹配的病例对照研究,按照单纯随机抽样方法收集平罗县2009年实验室确诊的成人麻疹病例60例和健康对照人群120例,对照按照同性别、同民族、互为邻居或同班级、年龄相差不超过2岁且既往无麻疹患病史的标准进行选择,并采用条件Logistic回归单因素分析方法筛选发病危险因素,采用条件Logistic回归多因素分析方法分析其主要危险因素。结果单因素分析结果显示：病例组中未接种麻疹疫苗的比例明显高于对照组（χ2=18.55,P〈0.01,OR=3.52,95%CI：1.98-6.23）,病例组中医院暴露的比例明显高于对照组（χ2=15.06,P〈0.01,OR=2.73,95%CI：1.64-4.52）,病例组中接触发热出疹性病人的比例明显高于对照组（χ^2=18.36,P〈0.01,OR=3.19,95%CI：1.88-5.42）,两组人群的家庭年人均收入水平差异有统计学意义（χ^2=4.27,P〈0.05,OR=1.71,95%CI：1.03-2.84）,两组人群的受教育水平差异无统计学意义（χ^2=0.49,P〉0.05,OR=0.86,95%CI：0.55-1.33）;进入Logistic回归模型的变量为麻疹疫苗接种史、医院暴露史、发热出疹性病人接触史,其回归系数分别为：1.61、1.14、1.02。结论未接种麻疹疫苗的人群、医院暴露人群、有发热出疹性病人接触史的人群、家庭年人均收入水平低的人群是平罗县成人麻疹发病的高危人群。

Analysis on Case-control Study of Adult Measles Outbreak in Pingluo Country of Ningxia

Objective To explore the relative effective factors of adult measles outbreak in Pingluo county. Methods 1：2 matched case - control study was used to collect the 60 adult cases who were diagnosed as measles by laboratory by random sampling and the 120 control people were selected on having the same sex, nationality, neighbour or class, age,whatinore, there was not history of sufferring from measles in the past ; to select the risk factors of this adult measles outbreak through one - way conditional logistic regression and to analyse the major risk factors through multi -way conditional logistic regression. Results One -way conditional logistic regression show ： The case group had lower proportion of measles vaccination （ Х^2 = 18.55, P 〈 0.01, OR = 3.52,95 % CI ： 1.98 - 6.23 ）. The ease group had higher proportion in exposure history of hospital （ Х^2 = 15.06,P 〈 0.01, OR = 2.73,95% CI ： 1.64 - 4.52） than the con- trol group with statistical significance. The case group had higher proportion in history of contacting with the patients who felt hot and sent out exanthema（ Х^2 = 18.36 ,P 〈 0.01, OR = 3.19,95% CI：I. 88 -5.42） than the control group with statistical significance. At the same time, statistically significant correlation was found between adult measles and family income level per capita（ Х^2 = 4.27 ,P 〈 0.05, OR = 1.71,95% CI： 1.03 -2.84） by single -factor statistical analysis. There was not statistical significance between adult measles and educational level（ Х^2 = 0.49, P 〉 0.05, OR = 0.86,95 % CI：0.55 - 1.33 ）. The analysis of conditional Logistic regression indicated that history of measles vaccination , exposure history of hospital, history of contacting with the measles patients had entered into regression, the regression coefficient was 1.61,1.14,1.02. Conclusion It showed that the people vaccination, exposure history of hospital, history of contacting with the patients who felt hot and sent out exanthema and lower family income level per capita were the high dangerous crowd of measles in pingluo county.