CAJ | 학술논문

目的总结2003年以来合肥流行性脑脊髓膜炎(流脑)的临床特征,为今后的流脑防治工作积累经验.方法对65例流脑患者的临床资料进行凹顾性分析,统计分析采用卡方检验.结果患者主要集中在青少年和成人,分别为29例(44.6%)和23例(35.4%),婴幼儿最少,仅4例(6.2%).临床分型以普通型为主,占72.3%,暴发型占27.7%,死亡5例(7.7%).共分离出33株脑膜炎奈瑟菌,培养阳性率为50.8%(33/65例),其中,血培养阳性率为44.6%(29/65例),脑脊液培养阳性者占31.4%(16/51例).药物敏感结果显示,无论是C群脑膜炎奈瑟菌还是其他群,对青霉素、头孢曲松、头孢噻肟等普遍敏感,而对复方磺胺甲(噁)唑、庆大霉素、环丙沙星等耐药率都在80%以上.血清学分类显示,高达82.8%(53/64例)的患者为C群菌株感染,与其他群流脑比较,C群感染者病情重,病死率高.结论 C群脑膜炎奈瑟菌已成为目前安徽省流脑流行的主要菌株,C群感染者多见于青少年和成人.治疗以青霉素、第三代头孢菌素类抗菌药物为佳.
목적 총결2003년이래합비류행성뇌척수막염(류뇌)적림상특정,위금후적류뇌방치공작적루경험.방법 대65례류뇌환자적림상자료진행요고성분석,통계분석채용잡방검험.결과 환자주요집중재청소년화성인,분별위29례(44.6%)화23례(35.4%),영유인최소,부4례(6.2%).림상분형이보통형위주,점72.3%,폭발형점27.7%,사망5례(7.7%).공분리출33주뇌막염내슬균,배양양성솔위50.8%(33/65례),기중,혈배양양성솔위44.6%(29/65례),뇌척액배양양성자점31.4%(16/51례).약물민감결과현시,무론시C군뇌막염내슬균환시기타군,대청매소、두포곡송、두포새우등보편민감,이대복방광알갑(오)서、경대매소、배병사성등내약솔도재80%이상.혈청학분류현시,고체82.8%(53/64례)적환자위C군균주감염,여기타군류뇌비교,C군감염자병정중,병사솔고.결론 C군뇌막염내슬균이성위목전안휘성류뇌류행적주요균주,C군감염자다견우청소년화성인.치료이청매소、제삼대두포균소류항균약물위가.
Objective To investigate the clinical and epidemiologieal feat ures of epidemic cerebrospinal meningitis in recent 3 years,aiming to develop the strategies for controlling this disease.Methods A retrospective analysis was conducted in 65 hospitalized patients with epidemic cerehrospinal meningitis from 2003 to 2006.Chi-square test was used for statistical analysis.Results The majority of these 65 patients were juvenile and adult,accounting for 44.6%(29 cases)and 35.4%(23 cases),respectively,while the infant patients account for the smallest percentage,only 6.2%(4 cases).Most cases occurred in spring(from February to April).The clinical features of most patients belonged to common type(72.3%),followed by fulminant type(27.7%).Five cases(7.7%)died,all of whom were fulminant cases.Totally 33 strains of Neisseria meningitidis were isolated,with positive culture rate of 50.8%(33/65 cases).The positive rate of blood culture was 44.6%(29/65 cases)and that of cerebrospinal fluid cuhure was 31.4%(16/51 cases).Isolates of Neisseria meningitidis were still highly sensitive to penicillin,ceftriaxone and cefotaxime.However,the resistance rates of strains to compound sulfamethoxazole,gentamycin and ciprofloxacin were all above 80%.Resuhs of serological typing revealed thai 82.8%(53/64 cases)cases belonged to group C.There were more severe cases and higher death rate in patients infected by group C meningococcus.Conclusions Serogroup C of the meningococcus have become the preponderant strains in Anhui Province.Most of the patients infected hy group C are J uveniles and adults.Penicillin and the third generation cephalosporins are still highly aclive againsl Neisseria meningitidis.