CAJ | 학술논문

目的探讨广东地区恙虫病患者胸部影像学改变与临床特征之间的关系.方法将1999年至2010年来自暨南大学附属第一医院、广州市第八人民医院、韶关市粤北第二人民医院住院的148例恙虫病患者分为胸部X线片异常组和胸部X线片正常组,采用t检验、#检验或Fisher确切概率法进行统计学分析,比较两组患者的临床特点及其预后.结果 148例恙虫病患者中,胸部影像学异常66例,占44.6％.胸部X线片异常组的咳嗽、严重血小板减少、低白蛋白血症、休克、急性呼吸衰竭、黄疸及急性肾功能衰竭的发生率明显高于胸部X线片正常组(χ2=18.193、6.872、17.138、5.608、4.318、7.982和7.932,均P＜0.05).胸部X线片正常组住院时间为(9.9±5.0)d,少于胸部X线片异常组的(11.7±7.1)d,但差异无统计学意义(t=1.717,P=0.088).胸部X线片异常组病死率为6.1％,高于胸部X线片正常组的0(Fisher确切概率法,P=0.038).结论恙虫病患者临床表现复杂多样,伴发胸部X线片异常很可能提示严重的恙虫病,应仔细分析病情,及时进行正确诊治.
목적 탐토엄동지구양충병환자흉부영상학개변여림상특정지간적관계.방법 장1999년지2010년래자기남대학부속제일의원、엄주시제팔인민의원、소관시월북제이인민의원주원적148례양충병환자분위흉부X선편이상조화흉부X선편정상조,채용t검험、#검험혹Fisher학절개솔법진행통계학분석,비교량조환자적림상특점급기예후.결과 148례양충병환자중,흉부영상학이상66례,점44.6％.흉부X선편이상조적해수、엄중혈소판감소、저백단백혈증、휴극、급성호흡쇠갈、황달급급성신공능쇠갈적발생솔명현고우흉부X선편정상조(χ2=18.193、6.872、17.138、5.608、4.318、7.982화7.932,균P＜0.05).흉부X선편정상조주원시간위(9.9±5.0)d,소우흉부X선편이상조적(11.7±7.1)d,단차이무통계학의의(t=1.717,P=0.088).흉부X선편이상조병사솔위6.1％,고우흉부X선편정상조적0(Fisher학절개솔법,P=0.038).결론 양충병환자림상표현복잡다양,반발흉부X선편이상흔가능제시엄중적양충병,응자세분석병정,급시진행정학진치.
Objective To investigate the relationship between chest radiographic changes and clinical manifestations in patients with scrub typhus in Guangdong area.Methods A total of 148 cases of scrub typhus admitted to First Affiliated Hospital of Ji′nan University,Guangzhou Eighth People′s Hospital and the Second People′s Hospital of Yuebei between 1999 and 2010 was retrospectively reviewed.The patients were divided into two groups based on the findings of the chest X-rays (with or without radiographic abnormalities).Furthermore,the clinical characteristics and prognosis in two groups were compared.The statistical analysis was done using t test,chi-square test or Fisher′s exact test.Results Chest X-rays showed abnormalities in 66 (44.6％) cases,and the chest X-ray features were diverse.The incidences of cough,severe thrombocytopenia,hypoalbuminemia,shock,acute respiratory failure,jaundice and acute renal failure were all significantly increased in group of patients with chest X-rays abnormalities compared with the other group of patients without chest X-rays abnormalities (χ2 =18.193,6.872,17.138,5.608,4.318,7.982 and 7.932,respectively; all P＜0.05).The hospitalization day was longer in patients with chest X-rays abnormalities compared with the patients without chest X-rays abnormalities,but there was no statistical difference [(11.7±7.1)d vs (9.9±5.0)d,t=1.717; P=0.088)],while the mortality was higher(6.1 ％ vs 0; Fisher′s exact test,P =0.038).Conclusions The clinical manifestations of the patients with scrub typhus are diverse,and the presence of abnormal chest X-rays is shown to be associated with the disease severity.Physicians should have the awareness of scrub typhus to make the diagnosis and treatment properly.