沂蒙山区秋冬季型恙虫病236例临床资料综合分析

A Clinical Data Analysis on 2 3 6 Cases of Tsutsugamushi Disease of Autumn and Winter Types in Yimeng Mountain Area

１９８６～１９８９年，每年秋冬季节，山东沂蒙山区有恙虫病发生，作者对２３６例恙虫病临床资料进行了分析。所有病例均发热３８℃～４１℃之间，皮疹１９９例（８４．３％），淋巴结肿大２０４例（８６．４％），出现溃疡或焦痂１６７例（７０．８％）。发热、皮疹、淋巴结肿大、溃疡或焦痂四种主要症状同时出现者１５０例（６３．６％）。半数病例白细胞增加，最高达１９．８×１０９／Ｌ，最低２．７８×１０９／Ｌ。１４份病人血液做酶标检测均阳性，最高滴度ＩｇＧ１：５１２０，ＩｇＭ１：２０４８０；１２份病人血液做免疫荧光阳性１１份；并从病人血液、黑线姬鼠，小盾纤恙螨分离出恙虫病立克次体，属Ｇｉｌｌｉａｍ血清型。

The tsutsugamushi disease were discovered in Yimeng Mountain Area , Shandong Province every year in 1986 - 89. An analysis on the clinical data of 236 cases of the disease was reported. All of them had a fever of 38- 41 degree centigrade; Among them there were 199 cases of skin rash(84. 3%) ,204 cases of lymphadenectasis(86. 4% )and 167 cases of ulcerate or eschar(70. 8% ). 150 cas- es hadall the four symptoms(63.6%).About half of the cases have leucocytosis with thehighest of 19. 8×109/L and the lowest of 2. 78×109/L. 14 patients' blood were positive with the highest titter of IgG 1 : 20480 in ELISA test,immunofluorescence test was made for 12 patients'blood,of which 11 were positive. Rickettsia tsutsugamushi was isolated from patient's blood , Apodemus agrarians and Lep- tofrombidium scutellare and it was typed of Gillian blood serum type.