CAJ | 학술논문

目的对佛山市某高中(S学校)学生出现不明原因双足疼痛暴发进行调查.方法疑似病例定义为2014年2月10日至3月16日佛山市S学校的学生和教职工中出现无明确原因足部疼痛或麻木者.病例定义为疑似病例中同时具有足部疼痛和麻木者.通过查阅学校附近医院就诊记录和校医务室门诊日志、查看学校因病缺勤记录搜索病例.制订统一的临床症状信息调查表,首先培训班主任老师,由班主任给各自班级学生进行讲解,并由学生填写调查问卷.收集佛山市2014年1月1日至3月31日的每日湿度,分析气候变化及每日温度与疾病发生的关系.在全校随机抽取14个班级开展病例对照研究,比较病例组和对照组的学习运动情况、膳食和保暖措施等.结果共407例学生病例,罹患率为26.5％(407/1 536).女生罹患率为37.3％ (320/859),高于男生(12.9％,87/677),差异有统计学意义(x2=115.1,P＜0.01).住宿生罹患率为31.8％(323/1016),高于走读生(16.2％,84/520),差异有统计学意义(x2=43.2,P＜0.01).住宿女生罹患率(46.1％,269/584)高于走读生(18.5％,51/275),差异有统计学意义(x2=61.4,P＜0.01),住宿男生罹患率(12.2％,54/442)和走读生(14.0％,33/235)差异无统计学意义(x2=0.13,P＞0.05).2014年2月6-13日气温迅速从23℃下降至6℃,随后气温持续回升,至2月28日升至23℃.短期内气温呈现“V”形变化.2月13-28日等级相关分析显示,每日病例数与最高温度呈正相关关系(r=0.65,P=0.002).病例对照研究结果显示,住宿生夜晚感觉被子凉(OR=3.0,95％CI:1.3～7.0)、平时缺乏体育锻炼(OR=2.8,95％CI:1.5 ～ 5.6)、既往脚部有类似症状(OR=3.4,95％CI:1.1～11.0)是不明原因双足疼痛发病的危险因素.结论本次不明原因双足疼痛暴发可能与气温骤降骤升变化有关.
목적 대불산시모고중(S학교)학생출현불명원인쌍족동통폭발진행조사.방법 의사병례정의위2014년2월10일지3월16일불산시S학교적학생화교직공중출현무명학원인족부동통혹마목자.병례정의위의사병례중동시구유족부동통화마목자.통과사열학교부근의원취진기록화교의무실문진일지、사간학교인병결근기록수색병례.제정통일적림상증상신식조사표,수선배훈반주임로사,유반주임급각자반급학생진행강해,병유학생전사조사문권.수집불산시2014년1월1일지3월31일적매일습도,분석기후변화급매일온도여질병발생적관계.재전교수궤추취14개반급개전병례대조연구,비교병례조화대조조적학습운동정황、선식화보난조시등.결과 공407례학생병례,리환솔위26.5％(407/1 536).녀생리환솔위37.3％ (320/859),고우남생(12.9％,87/677),차이유통계학의의(x2=115.1,P＜0.01).주숙생리환솔위31.8％(323/1016),고우주독생(16.2％,84/520),차이유통계학의의(x2=43.2,P＜0.01).주숙녀생리환솔(46.1％,269/584)고우주독생(18.5％,51/275),차이유통계학의의(x2=61.4,P＜0.01),주숙남생리환솔(12.2％,54/442)화주독생(14.0％,33/235)차이무통계학의의(x2=0.13,P＞0.05).2014년2월6-13일기온신속종23℃하강지6℃,수후기온지속회승,지2월28일승지23℃.단기내기온정현“V”형변화.2월13-28일등급상관분석현시,매일병례수여최고온도정정상관관계(r=0.65,P=0.002).병례대조연구결과현시,주숙생야만감각피자량(OR=3.0,95％CI:1.3～7.0)、평시결핍체육단련(OR=2.8,95％CI:1.5 ～ 5.6)、기왕각부유유사증상(OR=3.4,95％CI:1.1～11.0)시불명원인쌍족동통발병적위험인소.결론 본차불명원인쌍족동통폭발가능여기온취강취승변화유관.
Objective To identify the cause of an outbreak of foot pain syndrome among students from a senior high school in Foshan.Methods We defined a suspect case as onset of foot pain/numbness with unknown reason among students and teachers in a school of Foshan city,from February 10 to March 16,2014.A suspect case was noticed as having both food pain and numbness.All the cases were searched through reviewing medical records in the nearby hospitals and school's clinic,also the records of absenteeism in school.Clinical information was collected from all the students,using a standardized questionnaire.Daily temperature was collected from all the students,between January 1 and March 31,2014.A 1 ∶ 2 individual matched case-control study was conducted to identify related risk factors on this epidemic.We interviewed all the cases and controls on their diet,physical activities and measures used for warming.Results A total of 407 case-students were identified,with an attack rate (AR) as 26.5％.The AR was 37.3％ in girls,compared to 12.9％ in boys.The difference was statistically significant (x2 =115.1,P＜ 0.01).Boarding students had a higher AR (31.8％) than the commuting students (16.2％).The difference was statistically significant (x2=43.2,P＜0.01).In girls,boarding students had higher AR (46.1％) than those commuting students (18.5％).The difference was statistically significant (x2=61.4,P＜0.01).No statistically significant difference was found between boarding or commuting students in boys.Outdoor temperature was coming down from 23 ℃ on February 6 to 6 ℃ on February 13,but gradually rose to 23 ℃ on February 28.There was a positive relationship (r=0.65,P=0.002) noticed between daily maximum temperature and the number of cases during February 13-28.Results from this case-control study showed that factors as lacking physical activities (OR=2.8,95％ CI:1.5-5.6),feeling cold in bed (OR=3.0,95％ CI:1.3-7.0) and having experienced similar symptoms (OR=3.4,95％ CI:1.1-11.0) could increase the risk of this disease.Conclusion This outbreak was possibly caused by the abrupt fluctuation of temperature within a short period.