CAJ | 학술논문

目的：了解甘肃省＜8月龄及≥15岁人群麻疹发病危险因素，为制定针对性控制措施提供依据。方法选择＜8月龄及≥15岁实验室确诊麻疹病例，采用1∶3病例对照研究方法，分别研究病例组和对照组在医院暴露史、与发热出疹病例接触史、患病史、疫苗接种史、人口流动情况等因素的差异，从而分析患病的危险因素和提出控制措施。结果对42例＜8月龄病例和126例对照、74例≥15岁病例和222例对照进行分析，“医院暴露史”、“与发热出疹病例接触史”、“发病前去过其他城市”是＜8月龄及≥15岁人群麻疹发病的危险因素，“疫苗接种史”是≥15岁人群的保护因素。多因素分析显示，“医院暴露史”是＜8月龄儿童发生麻疹的唯一危险因素（OR＝29.23，95%CI：2.82～302.89）；“医院暴露史”及“发病前7～21 d去过其他城市”是≥15岁人群发生麻疹的危险因素（OR＝5.15，95%CI：2.28～11.63；OR＝5.48，95%CI：1.38～21.69）。结论降低＜8月龄及≥15岁人群麻疹发病，除提高免疫接种年龄范围内儿童麻疹类疫苗接种率和减少传染源外，必须加强医院内感染控制。
목적：료해감숙성＜8월령급≥15세인군마진발병위험인소，위제정침대성공제조시제공의거。방법선택＜8월령급≥15세실험실학진마진병례，채용1∶3병례대조연구방법，분별연구병례조화대조조재의원폭로사、여발열출진병례접촉사、환병사、역묘접충사、인구류동정황등인소적차이，종이분석환병적위험인소화제출공제조시。결과대42례＜8월령병례화126례대조、74례≥15세병례화222례대조진행분석，“의원폭로사”、“여발열출진병례접촉사”、“발병전거과기타성시”시＜8월령급≥15세인군마진발병적위험인소，“역묘접충사”시≥15세인군적보호인소。다인소분석현시，“의원폭로사”시＜8월령인동발생마진적유일위험인소（OR＝29.23，95%CI：2.82～302.89）；“의원폭로사”급“발병전7～21 d거과기타성시”시≥15세인군발생마진적위험인소（OR＝5.15，95%CI：2.28～11.63；OR＝5.48，95%CI：1.38～21.69）。결론강저＜8월령급≥15세인군마진발병，제제고면역접충년령범위내인동마진류역묘접충솔화감소전염원외，필수가강의원내감염공제。
Objective To understand the risk factors of measles among babies under 8-months-old and people ≥15 years old,in Gansu province. Methods Laboratory-confirmed measles cases were divided into two groups among children below 8-months-old and those≥15 year olds. Descriptive epidemiology and 1∶3 case control study were conducted to find out those related risk factors as:hospital exposure,contact with measles cases,vaccination,history of measles etc. so as to determine the risk factors and appropriate control measures. Results Histories of hospital exposure,contact with measles cases and travelling to other cities were risk factors for measles among babies younger than 8-months and people≥15 year olds. Vaccination appeared a protective factor for people ≥15 years of age. From 42 cases and 126 controls,through multivariate analysis,results showed that hospital exposure was the only significant factor(OR=29.23,95%CI:2.82-302.89)for those babies younger than 8-months. Factors as hospital exposure and travelling among cities for 7-21 days before being infected,were with significant importance(OR=5.15,95%CI:2.28-11.63;OR=5.48,95%CI:1.38-21.69)for people ≥15 years of age,according to the observation from 74 cases and 222 controls. Conclusion In order to reduce the incidence of measles among babies under 8-month-old and people ≥15 years old, efforts on control of nosocomial infection should be strengthened,while the routine immunization coverage need to be increased for the children at higher risks,to reduce the source of infection.