中华传染病杂志
中華傳染病雜誌
중화전염병잡지
CHINESE JOURNAL OF INFECTIOUS DISEASES
2015年
2期
75-78
,共4页
周麟玲%刘博%常爱娜%徐胜楠
週麟玲%劉博%常愛娜%徐勝楠
주린령%류박%상애나%서성남
发热%白细胞减少%血小板减少%多脏器功能损害%预后%新型布尼亚病毒
髮熱%白細胞減少%血小闆減少%多髒器功能損害%預後%新型佈尼亞病毒
발열%백세포감소%혈소판감소%다장기공능손해%예후%신형포니아병독
Fever%Leukopenia%Thrombocytopenia%Multi organ dysfunction%Prognosis%Novel bunyavirus
目的 回顾性分析新型布尼亚病毒感染患者的临床特征及其预后.方法 收集威海市文登中心医院经实验室确诊的68例新型布尼亚病毒感染的住院患者的临床资料,分析其流行病学、临床表现、实验室检测结果及预后的特征.结果 68例患者中有貂类养殖史或被貂咬伤史22例(32.4％),发病2周内蜱虫叮咬史4例(5.9％),因陪护新型布尼亚病毒感染的重症患者发病5例(7.4％),25例(36.8％)患者均有野外作业史;年龄＞60岁34例(50.0％),有基础疾病27例(39.7％).所有患者首发症状均为发热,伴有食欲不振、乏力等全身中毒症状,并出现多系统功能损害;伴神经系统损害27例(39.7％),消化道出血4例(5.9％)及快速心房颤动10例(14.7％),合并肺炎18例(26.5％).血白细胞计数≤2.0×109/L 55例(80.9％),血小板计数≤30×109/L 18例(26.5％);肝功能损害62例(91.2％),心肌酶升高68例(100.0％);活化部分凝血活酶时间延长44例(64.7％);低血钠23例(33.8％)、低血钾29例(42.6％)、低血钙36例(82.4％),高血糖49例(72.1％);新型布尼亚病毒核酸定量在1.10×102～5.78×107组织培养感染剂量(TCID)/mL.治愈55例,占80.9％,死亡13例,占19.1％.结论 与貂及患者密切接触、蜱虫叮咬、野外作业人群是新型布尼亚病的易感人群,高龄、有基础疾病、伴严重神经系统损害、出血、肺炎、血小板计数显著降低、心肌酶显著升高、高病毒载量者预后较差.
目的 迴顧性分析新型佈尼亞病毒感染患者的臨床特徵及其預後.方法 收集威海市文登中心醫院經實驗室確診的68例新型佈尼亞病毒感染的住院患者的臨床資料,分析其流行病學、臨床錶現、實驗室檢測結果及預後的特徵.結果 68例患者中有貂類養殖史或被貂咬傷史22例(32.4％),髮病2週內蜱蟲叮咬史4例(5.9％),因陪護新型佈尼亞病毒感染的重癥患者髮病5例(7.4％),25例(36.8％)患者均有野外作業史;年齡＞60歲34例(50.0％),有基礎疾病27例(39.7％).所有患者首髮癥狀均為髮熱,伴有食欲不振、乏力等全身中毒癥狀,併齣現多繫統功能損害;伴神經繫統損害27例(39.7％),消化道齣血4例(5.9％)及快速心房顫動10例(14.7％),閤併肺炎18例(26.5％).血白細胞計數≤2.0×109/L 55例(80.9％),血小闆計數≤30×109/L 18例(26.5％);肝功能損害62例(91.2％),心肌酶升高68例(100.0％);活化部分凝血活酶時間延長44例(64.7％);低血鈉23例(33.8％)、低血鉀29例(42.6％)、低血鈣36例(82.4％),高血糖49例(72.1％);新型佈尼亞病毒覈痠定量在1.10×102～5.78×107組織培養感染劑量(TCID)/mL.治愈55例,佔80.9％,死亡13例,佔19.1％.結論 與貂及患者密切接觸、蜱蟲叮咬、野外作業人群是新型佈尼亞病的易感人群,高齡、有基礎疾病、伴嚴重神經繫統損害、齣血、肺炎、血小闆計數顯著降低、心肌酶顯著升高、高病毒載量者預後較差.
목적 회고성분석신형포니아병독감염환자적림상특정급기예후.방법 수집위해시문등중심의원경실험실학진적68례신형포니아병독감염적주원환자적림상자료,분석기류행병학、림상표현、실험실검측결과급예후적특정.결과 68례환자중유초류양식사혹피초교상사22례(32.4％),발병2주내비충정교사4례(5.9％),인배호신형포니아병독감염적중증환자발병5례(7.4％),25례(36.8％)환자균유야외작업사;년령＞60세34례(50.0％),유기출질병27례(39.7％).소유환자수발증상균위발열,반유식욕불진、핍력등전신중독증상,병출현다계통공능손해;반신경계통손해27례(39.7％),소화도출혈4례(5.9％)급쾌속심방전동10례(14.7％),합병폐염18례(26.5％).혈백세포계수≤2.0×109/L 55례(80.9％),혈소판계수≤30×109/L 18례(26.5％);간공능손해62례(91.2％),심기매승고68례(100.0％);활화부분응혈활매시간연장44례(64.7％);저혈납23례(33.8％)、저혈갑29례(42.6％)、저혈개36례(82.4％),고혈당49례(72.1％);신형포니아병독핵산정량재1.10×102～5.78×107조직배양감염제량(TCID)/mL.치유55례,점80.9％,사망13례,점19.1％.결론 여초급환자밀절접촉、비충정교、야외작업인군시신형포니아병적역감인군,고령、유기출질병、반엄중신경계통손해、출혈、폐염、혈소판계수현저강저、심기매현저승고、고병독재량자예후교차.
Objective To retrospectively analyze the clinical characteristics,prognosis and risk factors of novel bunyavirus infection.Methods The clinical data of 68 patients with novel bunyavirus infection confirmed by laboratory diagnosis at Wendeng Central Hospital of Weihai were retrospectively collected.Epidemiological characteristics,clinical manifestations,physical signs and laboratory results were analyzed.Results Twenty two patients (32.4 ％) had intimate contact with ermine (breeding ermine or ermine biting) ; 4 patients (5.9％) had been bitten by tick within 2 weeks,6 patients (7.4％) had intimate contact with patients with severe fever with thrombocytopenia syndrome (SFTS) ; and 25 patients (36.8 ％) had a history of fieldwork before the onset of the disease.Thirty-four patients (50.0 ％) were over 60 years old and 27 cases (39.7％) had underlying diseases.Initial symptoms in all patients were fever accompanied by loss of appetite,fatigue and other toxemic symptoms,followed by multi organ damage.Other clinical manifestations included nervous system damage (27 cases,39.7％),hemorrhage (4 cases,5.9％),rapid atrial fibrillation (10 cases,14.7％) and pneumonia (18 cases,26.5％).White blood cell count of 55 cases (80.9％) was less than or equal to 2.0 × 109/L,platelet count of 18 cases (26.5％) was less than or equal to 30 × 109/L.Abnormal hepatic function was found in 62 cases (91.2％); elevated myocardial enzymes was found in 68 cases (100.0％),prolonged activated partial thromboplastin time in 44 cases (64.7％),hyponatremia in 23 cases (33.8％),hypokalemia in 29 cases (42.6％),hypocalcemia in 36 cases (82.4％),hyperglycemia in 49 cases (72.1％).Serum nucleic acid quantitation of novel bunyavirus varied from 1.10 × 102 to 5.78 × 107 tissue culture infective dose (TCID)/ mL.Fifty five cases were cured,accounting for 80.9 ％,while 13 (19.1％) died eventually.Conclusions High risk factors of novel bunyavirus infection included intimate contact with ermine and infected patients,tick biting and fieldwork.Patients with elder age,underlying diseases,nervous system symptoms,hemorrhage,pneumonia,low platelet,high viral load and elevated myocardial enzymes may have poor progonsis.
