CAJ | 학술논문

目的研究人埃里希体病的流行病学和临床特点.方法回顾性分析21例人埃里希体病临床诊断病例的流行病学、临床表现、实验室检查、治疗以及预后.结果本次人埃里希体病流行地区位于湖北、河南两省交界区,疫区蜱活动性高.病例均为农民,年龄最大69岁,最小19岁,中位数为50岁,男女比约为2∶3.病例均无类似病例接触史,3例在起病前1周有明确蜱咬史.常见症状包括发热、腹泻、咳嗽、恶心呕吐、腹痛和咳痰;并发症包括出血、中毒性脑病、急性肾功能不全、继发感染和呼吸衰竭.常见实验室异常包括PLT减少,嗜酸粒细胞减少,血清乳酸脱氢酶、肌酸激酶和转氨酶升高,WBC减少,蛋白尿.9例患者行外周血涂片检查,其中1例中性粒细胞胞质中发现包涵体;17例行血清学检查,其中埃里希体抗体阳性5例.经多西环素和对症支持治疗,痊愈14例,病死7例,死亡病例平均年龄56岁.结论人埃里希体病是一种蜱传急性自然疫源性疾病,可累及多器官,高龄病例易发生并发症,预后较差.
목적 연구인애리희체병적류행병학화림상특점.방법 회고성분석21례인애리희체병림상진단병례적류행병학、림상표현、실험실검사、치료이급예후.결과 본차인애리희체병류행지구위우호북、하남량성교계구,역구비활동성고.병례균위농민,년령최대69세,최소19세,중위수위50세,남녀비약위2∶3.병례균무유사병례접촉사,3례재기병전1주유명학비교사.상견증상포괄발열、복사、해수、악심구토、복통화해담;병발증포괄출혈、중독성뇌병、급성신공능불전、계발감염화호흡쇠갈.상견실험실이상포괄PLT감소,기산립세포감소,혈청유산탈경매、기산격매화전안매승고,WBC감소,단백뇨.9례환자행외주혈도편검사,기중1례중성립세포포질중발현포함체;17례행혈청학검사,기중애리희체항체양성5례.경다서배소화대증지지치료,전유14례,병사7례,사망병례평균년령56세.결론 인애리희체병시일충비전급성자연역원성질병,가루급다기관,고령병례역발생병발증,예후교차.
Objective To investigate epidemiological and clinical features of human ehrlichiosis.Methods The epidemiological, clinical, laboratory, therapeutic and prognostic data of 21 clinically diagnosed cases of human ehrlichiosis were retrospectively analyzed. Results The epidemic regions where the ticks' activity was high located at the boundary between Hubei and Henan Provinces. All cases were farmers. The median age was 50 years ranged from 19 to 69 years. The male female ratio evident history of tick bite 1 week before the onset. The common symptoms included fever, diarrhea,cough, nausea and vomiting, abdominal pain and expectoration. The complications included hemorrhage, toxic encephalopathy, acute renal insufficiency, secondary infection and respiratory failure. The common abnormalities of routine lab data were thrombocytopenia, hypoeosinophilia,elevated lactate dehydrogenase, creatine kinase and aminotransferases, leucopenia and proteinuria.Nine cases were tested with peripheral blood smear and intracytoplasmic inclusions in neutrophils were found in one case. Seventeen cases were tested with serological assay and antibodies against Ehrlichia were positive in five cases. After doxycycline, symptomatic and supportive treatments, 14 cases were recovered and seven died. The average age of the deaths was 56 years. Conclusions Human ehrlichiosis is an acute tick-borne zoonosis and multiorgan could be involved. The older cases prone to develop complications and the prognosis is poor.