【摘要】 目的查明江西省某小学一起聚集性呕吐事件原因。方法病例定义:2013年9月13日至18日,在某小学学生中,出现呕吐、头痛、头晕、恶心、腹痛症状之一者。病例搜索采用各班级班主任分别询问的方式开展。原因探查采用回顾性队列研究,选择发病班级集中的三年级一班的所有学生为研究对象,回顾调查学生铁树果进食史及剂量。结果共搜索到病例18例,全部为学生,病例分布在2个班级,发病班级罹患率为19%(18/97),病例集中在4 h内发病,临床症状主要为呕吐(78%)、头晕(67%)、恶心(50%)、腹痛(44%)。61%(11/18)的病例乳酸脱氢酶升高,检测值中位数为286 U/L(范围:263~369 U/L);22%(4/18)的病例出现凝血4项异常;17%(3/18)的病例出现白细胞升高,检测值中位数为12×109/L,范围:(11~13)×109/L。食用铁树果是发病的主要危险因素(RR=+∞,Fisher确切概率P=0.00008)。结论本次聚集性呕吐事件为食用铁树果导致的中毒事件。更多还原

【Abstract】 Objective This work was to investigate and analyze the cause of cluster vomiting events in a primary school, Jiangxi Province. Methods Case definition in this study was the presence of one of symptoms such as vomiting, headache, dizziness,nausea, abdominal pain occurred to students or faculty in this elementary school and nearby residents from September 13 to 18,2013. Case collection was carried out by asking each class teacher. The cause was explored with retrospective cohort study, and all the students of class one in Grade three which included the majority of the cases were selected for a self-designed questionnaire survey for the information about cycads fruit- eating history and dosage. Results There were totally 18 poisoning cases from two classes, with an incidence of 19%. The symptoms included vomiting(78%), dizziness(67%), nausea(50%), abdominal pain(44%).Increase in the level of lactate dehydrogenase was observed in 61%(11/18) of the total cases, with a median value of 286 U/L(range:263 ~ 369 U/L). 22%(4/18) of the cases presented abnormal blood coagulation. 17%(3/18) had increased white blood cell level,with a median value of was 12×109/L(range: 11~13×109/L). As shown by the retrospective cohort study, eating cycad fruit was the cause of poisoning(RR=+∞, Fisher’s exact P=0.00008). Conclusion Cycad fruit was the main cause for the cluster vomiting event.更多还原