浙江省新型布尼亚病毒感染重症病例的临床特征及流行病学分析

clinical features and epidemiological analysis of severe fever with thrombocytopenia syndrome associated with bunyavirus infection in zhejiang province

目的 提高对新型布尼亚病毒感染患者的流行病学、临床特征、病变特点及其治疗的认识.方法 回顾性分析2011年5-7月浙江省舟山医院收治的5例重症新型布尼亚病毒感染患者临床资料,并结合相关文献对该病的临床特点进行分析.结果 5例重型患者典型临床表现为持续高热、全身肌肉酸痛、浅表淋巴结肿大、腹痛、腹泻伴消化道出血、血小板及白细胞进行性下降.白细胞和血小板可分别降至1.0×109/l和30×109/l以下,血小板在发病的第9～19天降至最低,随后1周左右恢复至正常.病程第7～10天,患者cd4+和cd8+t淋巴细胞数量急剧下降.结论 该病多发生于丘陵地区的中老年人.患者起病急,病情重,重症者易发生心、肝、肾等脏器功能损害.除蜱叮咬外,可能还有其他传播方式. abstract： objective to review the epidemiology,clinical characteristics,pathological changes and treatment of severe fever with thrombocytopenia syndrome (sfts) associated with the novel bunyavirus infection.methods clinical data of five cases of sfts from zhoushan hospital during may,2011 and july,2011 were retrospectively analyzed,and related literatures were also reviewed.results persistent high fever,sore muscles,enlarged superficial lymph nodes,abdominal pain,diarrhea with gastrointestinal hemorrhage,progressive decrease of phtelets and white blood cells were observed.the platelets deceased to 30 × 109/l during d9 and d19 after the onset,and recovered in about one week later.the white cells deceased to 1.0 x 109/l.cd4+ t and cd8+ t lymphocytes decreased remarkably during d7 and d10 after the onset.conclusions sfts usually occurs in middle and old aged people from hilly region.it is severe and has abrupt onset.damages on heart,liver and kidney may occur.in addition to tick bite,there may be other transmission ways.

Objective To review the epidemiology,clinical characteristics,pathological changes and treatment of severe fever with thrombocytopenia syndrome (SFTS) associated with the novel Bunyavirus infection.Methods Clinical data of five cases of SFTS from Zhoushan Hospital during May,2011 and July,2011 were retrospectively analyzed,and related literatures were also reviewed.Results Persistent high fever,sore muscles,enlarged superficial lymph nodes,abdominal pain,diarrhea with gastrointestinal hemorrhage,progressive decrease of phtelets and white blood cells were observed.The platelets deceased to 30 × 109/L during d9 and d19 after the onset,and recovered in about one week later.The white cells deceased to 1.0 x 109/L.CD4+ T and CD8+ T lymphocytes decreased remarkably during d7 and d10 after the onset.Conclusions SFTS usually occurs in middle and old aged people from hilly region.It is severe and has abrupt onset.Damages on heart,liver and kidney may occur.In addition to tick bite,there may be other transmission ways.