CAJ | 학술논문

目的：探讨成人麻疹临床发病的特点，以期早期诊断成人麻疹。方法收集2014年1月至2014年12月在感染疾病科发热门诊确诊的成人麻疹临床资料，采取血清检测麻疹病毒血清特异性 IgM 抗体，应用 RT - PCR 法检测麻疹病毒 N 基因片段。所有送检的疑似麻疹病人根据检测结果分为麻疹组和非麻疹组，分析成人麻疹和非麻疹感染的发病特点的差异。结果①麻疹组患者以外地来京或外来务工人员占多数，发病高峰在4、5月份。②临床表现中麻疹组患者高热、咳嗽、眼部症状、麻疹黏膜斑、肺炎的发生率均明显高于非麻疹组（ P ﹤0.05），而发热持续时间、皮疹异常循序、皮疹时间、胃肠道症状、支气管炎的发生率两组比较差异无统计学意义（ P ﹥0.05）。③实验室检查中麻疹组淋巴细胞绝对值与百分比明显下降（ P ﹤0.05）；肝功能中 ALT、CK - MB、LDH 明显升高（ P ﹤0.05）。结论成人麻疹临床表现不典型，提示对16岁以上青壮年进行麻疹疫苗加强接种，对降低麻疹患病率有重要意义。
목적：탐토성인마진림상발병적특점，이기조기진단성인마진。방법수집2014년1월지2014년12월재감염질병과발열문진학진적성인마진림상자료，채취혈청검측마진병독혈청특이성 IgM 항체，응용 RT - PCR 법검측마진병독 N 기인편단。소유송검적의사마진병인근거검측결과분위마진조화비마진조，분석성인마진화비마진감염적발병특점적차이。결과①마진조환자이외지래경혹외래무공인원점다수，발병고봉재4、5월빈。②림상표현중마진조환자고열、해수、안부증상、마진점막반、폐염적발생솔균명현고우비마진조（ P ﹤0.05），이발열지속시간、피진이상순서、피진시간、위장도증상、지기관염적발생솔량조비교차이무통계학의의（ P ﹥0.05）。③실험실검사중마진조림파세포절대치여백분비명현하강（ P ﹤0.05）；간공능중 ALT、CK - MB、LDH 명현승고（ P ﹤0.05）。결론성인마진림상표현불전형，제시대16세이상청장년진행마진역묘가강접충，대강저마진환병솔유중요의의。
Objective To analyze the 53 laboratory diagnosis of adult measles cases,to explore the clinical characteristics and analyze the clinical characteristic of adult measles,in order to early diagnose the adult measles. Methods We selected outpatients of suspected measles at the infection department of Jishuitan hospital between January 2014 and December 2014. To detect measles virus serum specific antibody of IgM and detection measles gene N by the method of RT - PCR . All suspected measles patients were divided into measles group and non measles group. Re-sults ①Most of the measles patients were foreign migrant workers,the peak time was in April and May. ②The incidence rate of measles patients with high fever,cough,eye symptoms,pneumonia,measles mucous plaque were significantly higher than those in non measles group( P ﹤ 0. 05) in the clinical manifestation,but the duration of fever,rash,the rash of abnormal sequential time,gastrointestinal symptoms,the incidence of two groups had no significant difference( P ﹥ 0. 05). ③Lymphocyte absolute value and percentage in the measles group decreased significantly( P﹤ 0. 05);ALT,CK - MB,LDH were significantly higher( P ﹤ 0. 05). Conclusion The clinical manifestation of measles is not typical,sug-gesting to strengthen vaccination on over 16 years old young,which has important significance to reduce the incidence rate of measles.