我国存在两种不同类型的阑尾炎实体

There are two different entities of appendicitis in China

目的:比较我国南方某中学阑尾炎爆发病例与其它地区阑尾炎爆发病例的特征以证实我国存在两种不同类型的阑尾炎实体。方法:比较不同地区爆发病例的流行病学特征、临床特征和组织学特征。结果:2004年1月至12月,该校出现阑尾炎病例18名,男女生的发病率分别为0.6%和9.8%(Z=2.77,P≤0.006)。病例常成簇出现,病例间常有接触史。极少数病例体温、白细胞和中性粒细胞百分比增高。全部为急性单纯性阑尾炎,组织学的特征为阑尾组织出血、淋巴细胞和嗜酸细胞浸润,与武汉某中学阑尾炎爆发病例特征一致。而西藏军营和武汉某学院病例与传统阑尾炎分类一致,有急性单纯性阑尾炎,急性化脓性阑尾炎,阑尾穿孔和阑尾周围脓肿。病例的体温和白细胞普遍增高。结论:我国存在两种类型的阑尾炎实体:一种与传统阑尾炎一致,另一种是新型非穿孔性阑尾炎,其发生可能与传染因子有关。

Objective:To compare the characteristics of appendicitis outbreak/cluster at a middle school in southern China with that in other regions,and to confirm the existence of two different entities of appendicitis in China.Methods:The epidemiological,clinical and histological characteristics of the outbreak/cluster cases of appendicitis in different areas were compared.Results:Eighteen cases of appendicitis occurred at this school from January to December 2004.The incidence of male and female students was 0.6%and 9.8%,respectively(Z=2.77,P≤0.006).Cases often occurred in clusters and there was often a history of contact among cases.In rare cases,the percentage of body temperature,white blood cells,and neutrophils increased.All cases were diagnosed as acute simple appendicitis.The histological features were appendiceal hemorrhage,lymphocyte and eosinophils infiltration,which were consistent with the characteristics of appendicitis in outbreak/cluster at a middle school in Wuhan.The cases of appendicitis of Tibet military camp and a college in Wuhan were consistent with the classification of classic appendicitis,including acute simple appendicitis,acute suppurative appendicitis,appendiceal perforation and periappendiceal abscess,which was featured with elevating body temperature and white blood cells.Conclusion:There are two kinds of appendicitis in China:one is consistent with the classic appendicitis,and the other is a new type of non-perforated appendicitis.