中华实验和临床感染病杂志(电子版)
中華實驗和臨床感染病雜誌(電子版)
중화실험화림상감염병잡지(전자판)
CHINESE JOURNAL OF EXPERIMENTAL AND CLINICAL INFECTIOUS DISEASES(ELECTRONIC VERSION)
2013年
5期
691-693
,共3页
丁立%刘曦%周耀勇%夏瑾瑜
丁立%劉晞%週耀勇%夏瑾瑜
정립%류희%주요용%하근유
恙虫病%恙虫病东方体%临床特征
恙蟲病%恙蟲病東方體%臨床特徵
양충병%양충병동방체%림상특정
Scrub typhus%Orientia tsutsugamushi%Clinical feature
目的:分析珠海市恙虫病的临床特点,提高临床诊断及治疗水平。方法回顾性分析珠海市88例恙虫病患者的临床资料,探讨其临床特点。结果65例患者(73.86%)发病前有草地/树林接触史。临床表现主要有发热(100%)、头痛(63.64%)、乏力(39.33%)、咳嗽(35.23%),淋巴结肿大(47.73%)、肝脾肿大(35.22%)、皮疹(29.55%)及特异性焦痂/溃疡(95.45%)等。外周血白细胞计数多正常(71.59%),可伴有嗜酸性粒细胞减少(78.41%)、血小板减少(38.64%),合并肝损害多见(87.5%)。共有84例患者送检外斐试验98例次,变形杆菌OXK凝集反应阳性效价12例次,阳性率12.24%。氯霉素、米诺环素、多西环素、克拉霉素治疗均有效。结论恙虫病临床表现多样,常累及多个系统,焦痂/溃疡为其最具诊断价值的特异体征,需仔细查体以免误诊。外斐试验阳性率低,不能单独做为诊断依据。氯霉素、四环素类及大环内酯类抗生素治疗效果好。
目的:分析珠海市恙蟲病的臨床特點,提高臨床診斷及治療水平。方法迴顧性分析珠海市88例恙蟲病患者的臨床資料,探討其臨床特點。結果65例患者(73.86%)髮病前有草地/樹林接觸史。臨床錶現主要有髮熱(100%)、頭痛(63.64%)、乏力(39.33%)、咳嗽(35.23%),淋巴結腫大(47.73%)、肝脾腫大(35.22%)、皮疹(29.55%)及特異性焦痂/潰瘍(95.45%)等。外週血白細胞計數多正常(71.59%),可伴有嗜痠性粒細胞減少(78.41%)、血小闆減少(38.64%),閤併肝損害多見(87.5%)。共有84例患者送檢外斐試驗98例次,變形桿菌OXK凝集反應暘性效價12例次,暘性率12.24%。氯黴素、米諾環素、多西環素、剋拉黴素治療均有效。結論恙蟲病臨床錶現多樣,常纍及多箇繫統,焦痂/潰瘍為其最具診斷價值的特異體徵,需仔細查體以免誤診。外斐試驗暘性率低,不能單獨做為診斷依據。氯黴素、四環素類及大環內酯類抗生素治療效果好。
목적:분석주해시양충병적림상특점,제고림상진단급치료수평。방법회고성분석주해시88례양충병환자적림상자료,탐토기림상특점。결과65례환자(73.86%)발병전유초지/수림접촉사。림상표현주요유발열(100%)、두통(63.64%)、핍력(39.33%)、해수(35.23%),림파결종대(47.73%)、간비종대(35.22%)、피진(29.55%)급특이성초가/궤양(95.45%)등。외주혈백세포계수다정상(71.59%),가반유기산성립세포감소(78.41%)、혈소판감소(38.64%),합병간손해다견(87.5%)。공유84례환자송검외비시험98례차,변형간균OXK응집반응양성효개12례차,양성솔12.24%。록매소、미낙배소、다서배소、극랍매소치료균유효。결론양충병림상표현다양,상루급다개계통,초가/궤양위기최구진단개치적특이체정,수자세사체이면오진。외비시험양성솔저,불능단독주위진단의거。록매소、사배소류급대배내지류항생소치료효과호。
Objective To analyse the clinical features of patients with scrub typhus in Zhuhai and improve the levels of clinical diagnosis and treatment. Methods The clinical data of 88 patients with scrub typhus in Zhuhai was analysed retrospectively. Results Total of 65 patients (73.86%) had a history of contact with grass or woods before illness onset. The clinical manifestations included fever (100%), headache (63.64%), fatigue (39.33%), cough (35.23%), lymphadenectasis (47.73%), hepatosplenomegaly (35.22%), rashes (29.55%) and specifical eschar or ulcer (95.45%), etc. The peripheral white blood cell count in the majority of patients (71.59%) was normal. Eosinophil decrease (78.41%) and thrombocytopenia (38.64%) were observed. Hepatitis (87.5%) was the most common complication. A total of 99 cases in 84 patients were tested Weil-Felix, among which 12 cases were positive in Proteus OXK agglutination reaction. The positive rate was only 12.24%. Chloramphenicol, Minocycline, doxycycline and clarithromycin treatment were all effective. Conclusions The clinical manifestations of scrub typhus, involving multisystem, are diverse. Eschar and ulcer are the most specific signs. The positive rate of Weil-Felix test is low. The diagnosis of scrub typhus could not just depend on Weil-Felix test. Chloramphenicol, tetracyclines and macrolides are all the effective drugs for this disease.