CAJ | 학술논문

目的分析86例黑热病患者相关临床资料,提高黑热病诊治水平.方法回顾性分析86例黑热病的流行情况、临床表现、实验室检查、诊治情况及转归.结果四川地区有黑热病流行疫区,发热、肝脾和淋巴结肿大、全血细胞减少及血浆球蛋白明显增高为黑热病主要临床表现.予葡萄糖酸锑钠正规治疗,总治愈率为95.3%(82/86),脾切除2例(2.3%),复发1例(1.2%),初始误诊率达30.2%.好转后自动出院3例.结论黑热病无特异的临床表现,误诊率较高,对疑诊患者应及早行骨髓涂片或组织活检,查找利什曼原虫无鞭毛体,结合39 ku蛋白重组抗原(rk39)检测,有利于及时诊治,减少并发症.葡萄糖酸锑钠仍是治疗黑热病安全、有效的首选药物.
목적 분석86례흑열병환자상관림상자료,제고흑열병진치수평.방법 회고성분석86례흑열병적류행정황、림상표현、실험실검사、진치정황급전귀.결과 사천지구유흑열병류행역구,발열、간비화림파결종대、전혈세포감소급혈장구단백명현증고위흑열병주요림상표현.여포도당산제납정규치료,총치유솔위95.3%(82/86),비절제2례(2.3%),복발1례(1.2%),초시오진솔체30.2%.호전후자동출원3례.결론 흑열병무특이적림상표현,오진솔교고,대의진환자응급조행골수도편혹조직활검,사조리십만원충무편모체,결합39 ku단백중조항원(rk39)검측,유리우급시진치,감소병발증.포도당산제납잉시치료흑열병안전、유효적수선약물.
Objective To improve the diagnosis and treatment based on the retrospective clinical analysis of 86 patients with leishmaniasis, an endemic disease caused by various species of Leishmania. Methods The data of 86 consecutive patients with visceral leishmaniasis and lymph node leishmaniasis were retrospectively reviewed, including epidemiological data, clinical manifestations, laboratory features, diagnosis, therapeutic procedures and prognosis. Results There were specific endemic zones of leishmaniasis in Sichuan province. The main clinical symptoms and signs in the initial evaluation were: fever (100%), splenomegaly (100%), enlarged lymph nodes with hepatosplenomegaly (58.1%). All patients were treated with sodium pentavalent antimony gluconate (SPAG). About 95.3% (82/86) of the patients were cured, 3.5% (3/86) improved, and 1.2% (1/86) relapsed. Splenotomy was carried out for 2.3% (2/86) of the patients. The misdiagnosis rate was 30.2%.Conclusions Visceral leishmaniasis has no specific manifestations and is easily misdiagnosed. If leishmaniasis is suspected, bone marrow biopsy and smear examination, lymph node biopsy, rk-39 strip test for visceral leishmaniasis pathogen should be done to improve the outcome. SPAG is the first choice for leishmaniasis chemotherapy.