人民卫生出版社系列期刊
ISSN 2096-2738 CN 11-9370/R

中国科技核心期刊(中国科技论文统计源期刊)
2020《中国学术期刊影响因子年报》统计源期刊

新发传染病电子杂志 ›› 2020, Vol. 5 ›› Issue (3): 173-177.doi: 10.19871/j.cnki.xfcrbzz.2020.03.007

• 论著 • 上一篇    下一篇

广西地区恙虫病77例临床特征分析

李莎1, 卢亦波2, 谢周华3   

  1. 1.南宁市第四人民医院,广西艾滋病临床治疗中心,广西医科大学附属南宁市传染病医院内科,南宁 530021;
    2.南宁市第四人民医院,广西艾滋病临床治疗中心,广西医科大学附属南宁市传染病医院放射科,南宁 530021;
    3.南宁市第四人民医院,广西艾滋病临床治疗中心,广西医科大学附属南宁市传染病医院结核科,南宁 530021
  • 收稿日期:2020-07-12 出版日期:2020-03-20 发布日期:2020-10-12
  • 通讯作者: 卢亦波,Email:13768415203@139.om
  • 基金资助:
    广西壮族自治区卫生健康委员会自筹经费科研课题(Z20201108)

Clinical characteristics of 77 cases of tsutsugamushi disease in Guangxi

Li Sha1, Lu Yibo2, Xie Zhouhua3   

  1. 1.Department of Internal Medicine, The Fourth People's Hospital of Nanning, Guangxi AIDS Clinical Treatment Center, Infectious Disease Hospital affiliated to Guangxi Medical University, Nanning 530021, China;
    2.Department of Radiology, The Fourth People's Hospital of Nanning, Guangxi AIDS Clinical Treatment Center, Infectious Disease Hospital affiliated to Guangxi Medical University, Nanning 530021, China;
    3.Department of Tuberculosis, The Fourth People's Hospital of Nanning, Guangxi AIDS Clinical Treatment Center, Infectious Disease Hospital affiliated to Guangxi Medical University, Nanning 530021, China
  • Received:2020-07-12 Online:2020-03-20 Published:2020-10-12

摘要: 目的 分析恙虫病患者的临床特点,为恙虫病的科学防控提供依据。方法 采用回顾性分析方法,收集2012–2020年广西南宁市传染病院收治的77例恙虫病患者的临床资料,分析患者的流行病学特征、临床特征、实验室检查、影像学检查、治疗及转归情况。结果 恙虫病患者中,发热、焦痂/溃疡占100%;肝损伤57.1%,肾损伤41.6%,中枢神经系统受损5.2%,多器官功能损伤15.6%。嗜酸性粒细胞降低39例(50.6%),贫血65例(84.4%),C反应蛋白升高67例(87.0%),铁蛋白升高73例(94.8%),红细胞沉降率增快67例(87.0%),白蛋白降低58例(75.3%),α-羟基丁酸脱氢酶升高60例(77.9%),乳酸脱氢酶升高64例(83.1%)。患者胸部影像学检查结果异常占61例(79.2%)。多西环素、左氧氟沙星、阿奇霉素治疗均有效。结论 恙虫病临床表现多样,可累及多个器官,发热、焦痂或溃疡为本病最具诊断价值的特异性体征,病程与器官损伤的发生率相关。及时有效抗菌治疗预后良好。

关键词: 恙虫病, 临床特征, 广西地区, 预后

Abstract: Objective To analyze the clinical characteristics of patients with tsutsugamushi disease, and provide the basis for scientific prevention and control of tsutsugamushi disease. Methods The clinical data of 77 cases of tsutsugamushi disease in Nanning infectious disease hospital from 2012 to 2020 were retrospectively collected. The epidemiological characteristics, clinical characteristics, laboratory examination, imaging examination, treatment and prognosis of the patients were analyzed. Results Among the patients with tsutsugamushi disease, the presence of fever and eschar/ ulcer accounted for 100%, with liver injury of 57.1%, kidney injury of 41.6%, central nervous system compromise of 5.2%, multiple organ function failure of 15.6%. There were 39 cases (50%) with eosinophilia, 65 cases (84.4%) with anemia, 67 cases (87%) with elevated C-reactive protein, 73 cases (94.8%) with elevated ferritin, 67 cases (87%) with increased ESR, 58 cases (75.3%) with decreased albumin, 60 cases (77.9%) with increased α-hydroxybutyrate dehydrogenase, and 64 cases (83%) with elevated lactate dehydrogenase. There were 61 cases (79.2%) with abnormal findings on chest imaging. The administration of Doxycycline, levofloxacin and azithromycin was effective treatment. Conclusion The clinical manifestations of tsutsugamushi disease varies, and could involve multiple organs. Fever, eschar or ulcer are the specific signs with the most diagnostic value. The course of disease is related to the incidence of organ injury. With timely and effective anti-bacterial treatment, this disease has a good prognosis.

Key words: Tsutsugamushi disease, Clinical characteristics, Guangxi region, Prognosis