摘要
目的了解广州地区恙虫病的流行病学及临床特点。方法对广州医学院第二附属医院1985~2012年收治的208例恙虫病患者的资料进行回顾性分析。结果所有病例均有草丛接触史;平均年龄为52.7岁,以50岁以上人群为主,年龄分布无明显性别差异;发病时间主要集中在5～10月份。大多数患者有明显的毒血症症状,主要临床表现及其发生率如下：发热（100%）、焦痂或溃疡192例（92.3%）、浅表淋巴结肿大117例（56.3%）、皮疹92例（44.2%）、肝脾肿大58例（27.9%）,病程中可发生中枢神经、血液、呼吸、消化、肾脏、心脏多个重要脏器的功能损害,外斐试验阳性122例（65.6%）。首诊确诊率为51.9%,病死率为6.7%。结论广州地区恙虫病的季节分布以夏季型和秋季型为主,该疾病表现为发病高龄化,临床表现复杂,多并发症,高误诊率等特点。因此,建议对医务人员进行恙虫病知识的定期培训,提高早期诊断能力。
Objective To understand the epidemiologic and clinical features of tsutsugamushi disease patients in Guangzhou.Methods The clinical data of 208 tsutsugamushi disease inpatients from 1986 to 2012 were retrospectively analyzed.Results All cases had a history of contacting grass and bush wood.The average age of these cases were 52.7 years old and the disease occurred mainly to cases over 50 years old.There was no correlation between age distribution and gender.The infections were mainly concentrated in May to October.Toxemic symptoms were observed in most cases.The main clinical manifestations and theirs incidences were as follows： all（100%） with fever,192 cases（92.3%） with typical eschars or ulcers,117 cases（56.3%） with superficial lymphadenectsis,92 cases（44.2%） with skin rashes and 58 cases（27.9%） with hepatosplenomegaly.Dysfunctions of multiple organs including central nervous system,blood system,respiratory system,digestive system,kidney and heart,were found in the course of the disease.Weil-Felix reaction showed that 122 cases（65.6%） were determined to be positive and 51.9% of these cases were confirmed by the initial diagnosis.The fatality rate of this group was 6.7%.Conclusion Tsutsugamushi disease mainly occurred in Summer and Autumn in Guangzhou with various clinical manifestations,multiple complications and high rate of misdiagnosis.Therefore,A regular training of medical workers be carried out for improving the diagnosis of tsutsugamushi disease..
出处
《中国热带医学》
CAS
2013年第6期709-712,共4页
China Tropical Medicine
关键词
恙虫病
恙虫病东方体
流行病学
临床特征
Tsutsugamushi disease
Oriental tsutsugamushi
Epidemiology
Clinical characteristics.
