CAJ | 학술논문

目的分析2014年广东省暴发流行登革热患者的临床和实验室特征,以期更好地防治登革热.方法回顾性分析广州市第八人民医院2014年收治的1 942例登革热住院患者的临床和实验室资料.免疫层析法和ELISA法测定登革病毒(DENV) IgM和IgG抗体;实时荧光PCR检测DENV核酸,并对部分标本进行核酸分型;分离DENV并进行型别鉴定.结果 1 942例登革热患者中,1 821例(93.8％)普通型登革热(DF)以青壮年为主,占69.0％;重症登革热(SD) 121例,占6.2％,均为成人,其中＞65岁老年人占52.0％.登革热患者血小板计数减少占79.8％.SD发生严重出血者占52.1％,休克占54.5％,71.9％的患者出现严重器官功能损害,其中并发心肌炎者占46.3％.163例患者ELISA法检测DENV IgM和IgG抗体,二次感染在DF和SD患者中分别占47.6％和55.0％.159例患者分型分析显示,83.6％为DENV-1型感染,5.7％为DENV-2型感染,10.7％为DENV-1型和DENV-2型混合感染.98.2％患者治愈出院,2例患者死于多器官功能衰竭.结论 2014年广东省暴发DENV-1和DENV-2感染所致的登革热大流行,大多数患者为成年人,血小板计数减少比例较高.SD患者高龄老年伴基础疾病者多,并发休克及重要脏器损伤比例高.
목적 분석2014년광동성폭발류행등혁열환자적림상화실험실특정,이기경호지방치등혁열.방법 회고성분석엄주시제팔인민의원2014년수치적1 942례등혁열주원환자적림상화실험실자료.면역층석법화ELISA법측정등혁병독(DENV) IgM화IgG항체;실시형광PCR검측DENV핵산,병대부분표본진행핵산분형;분리DENV병진행형별감정.결과 1 942례등혁열환자중,1 821례(93.8％)보통형등혁열(DF)이청장년위주,점69.0％;중증등혁열(SD) 121례,점6.2％,균위성인,기중＞65세노년인점52.0％.등혁열환자혈소판계수감소점79.8％.SD발생엄중출혈자점52.1％,휴극점54.5％,71.9％적환자출현엄중기관공능손해,기중병발심기염자점46.3％.163례환자ELISA법검측DENV IgM화IgG항체,이차감염재DF화SD환자중분별점47.6％화55.0％.159례환자분형분석현시,83.6％위DENV-1형감염,5.7％위DENV-2형감염,10.7％위DENV-1형화DENV-2형혼합감염.98.2％환자치유출원,2례환자사우다기관공능쇠갈.결론 2014년광동성폭발DENV-1화DENV-2감염소치적등혁열대류행,대다수환자위성년인,혈소판계수감소비례교고.SD환자고령노년반기출질병자다,병발휴극급중요장기손상비례고.
Objective To analyze the clinical and laboratory features of patients with dengue fever during the outbreak in Guangdong in 2014 and for better prevention and control of dengue fever.Methods Clinical and laboratory data from 1 942 hospitalized patients with dengue fever during the outbreak in 2014 were retrospectively analyzed.Anti-dengue virus antibodies IgM and IgG were detected by enzyme immuno chromatography method and enzyme linked immunosorbent assay (ELISA).Dengue virus (DENV) RNA was detected by real-time fluorescence polymerase chain reaction.DENV types were identified or virus were isolated by C6/36 cell culture and then typed.Results Of all the 1 942 patients,1 821(93.8％) were diagnosed as ordinary dengue fever (DF).Many patients (69.0％) with DF were young adults,121 (6.2 ％) were diagnosed as severe dengue (SD).All the patients were adults,with the elderly people over the age of 65 years accounting for 52.0％.The decreased platelets count was seen in 79.8％ patients with dengue fever.Severe bleeding and shock in SD patients were seen in 52.1％ and 54.5％,respectively.The severe organ damage was seen in 71.9％ SD patients,of which 46.3％ had myocarditis.One hundred and sixty-three patients were DENV IgM and IgG positive detected by ELISA.The proportion of second infection in patients with DF and SD were 47.6％ and 55.0％,respectively.Virus type detection among 441 patients showed that 83.6 ％ patients were identified as DENV-1 infection,5.7％ were DENV-2 infection and 10.7％ were DENV-1 and DENV-2 co-infection.Of which 98.2％ patients were cured and 2 patients died of multiple organ failure.Conclusions The outbreak of dengue fever in Guangdong in 2014 is caused by the DENV-1 and DENV-2.Most of the patients are adults.More patients have platelets decrease.Patients with SD are more elderly people with underlying diseases and have higher proportion of shock and vital organs injury.