甲型副伤寒21例临床特征和药敏分析

Analysis of the clinical features and drug sensitivity of 21 cases patients with paratyphoid A

目的：探讨甲型副伤寒的临床特征和药物敏感特点。方法：回顾性分析21例甲型副伤寒患者（副伤寒组）的临床特征和药敏特点，与在中国学术期刊（光盘版）随机查找1994～1996年度的伤寒文献级（伤寒组）相比较。结栗：伤寒组和副伤寒组有伤寒及副伤寒中典型特征者、明显全身中毒症状者、相对缓脉、表情淡漠及脾肿大的发生率分别为86．1％、62．5％、36．4％、51％、12．6％和4．8％、38．1％、9．5％、52．9％，差异均有统计学意义（P〈0．05～P〈0．01）；发热、玫瑰疹及肝肿大的发生率分别为99．I％、14．1％、19．1％和100．0％、9．5％、29．4％，差异均无统计学意义（P〉0．05）。副伤寒组喹诺酮类药物敏感率100．0％，三代头孢敏感率90％以上。结论：甲型副伤寒临床症状不典型，中毒症状轻，脾肿大、相对缓脉和表情淡漠较多见。治疗首选喹诺酮类药物，次选第三代头孢菌素、氯霉素。

Objective： To analyze the clinical features and drug sensitivity of paratyphoid A. Methods： Twenty-one cases of paratyphoid A were analyzed retrospectively. The clinical features and drug sensitivity were compared with the cases selected randomly in Chinese Academic Journal（CD） from 1994 - 1996. Results： The presentation of typical characteristics of typhoid and paratyphoid was 86.1% and 4.8% in the typhoid group and paratyphoid A group respectively;obvious toxic symptoms were observed in 62.5% of the patients in the typhoid group and 38.1% in the paratyphoid A group;The incidence of relative infrequent pulse was 36.4% and 9.5% in the typhoid group and paratyphoid A group respectively; The apathia rate was 51% in the typhoid group and 9.5% in the paratyphoid A group;The incidence rate of enlarged spleen was 12.6% and 52.9% in the typhoid group and paratyphoid A group respectively （ P 〈 0.05 - P 〈 0.01 ）. The difference was significant. The incidence of fever, rose rash and hepatauxe was 99.1%, 14.1% and 19.1% in the typhoid group and 100% ,9.5% and 29.4% in the paratyphoid A group, respectively; the difference was not significant （P 〉0.05）. The sensitiveness rate of quinolones was 100% and the sensitiveness rate of the third generation ephamycins was above 90%. Conclusions： Clinical symptoms of paratyphoid A are not typical. Quinolones is the first medicine for treatment of paratyphoid A, and the third generation ephamycins and chlormycetin are the second choice.