恙虫病患者病程与器官损害及预后的关系

Corelation of course of tsutsugamshi disease with organic damage and prognosis

目的探讨及时诊断治疗对恙虫病患者器官损害数量、严重程度和预后的影响。方法对127例临床诊断为恙虫病的患者,按其发病时间、诊断和治疗时间与患者器官损害数量、严重程度及其治疗效果和预后进行对照分析。结果127例患者中,发病〈5d72例,合并一个器官损害59例（81.94%）,两个器官损害13例（18.06%）;发病5-10d28例,合并一个器官损害7例（25.00%）,两个器官损害16例（57.14%）,多个器官损害5例（17.86%）;发病11-14d18例,合并两个器官损害6例（33.33%）,多个器官损害12例（66.67%）;发病〉14d9例,100%均出现多个器官损害。发病〈5d及时诊断并予治疗者63例全部治愈（100%）;发病后5-10d诊断并予治疗32例,治愈31例（96.88%）,死亡1例;发病后11-14d诊断并予治疗20例,治愈19例（95.00%）,死亡1例;发病〉14d诊断并予治疗12例,治愈10例（83.33%）,死亡2例。结论恙虫病发病时间越长,并发器官损害数量越多,发生多器官功能衰竭的机会越大,死亡率越高。早期诊断和予以有效药物治疗是影响恙虫病患者预后的重要因素。

Objective To explore the relationship between course of illness and the degree of multiorgan damage and the prognosis in patents with tsutsagamushi disease. Methods There 127 patents with tsutsugamushi disease were clinically analized. Results The onset time of 72 cases was in 5 days, 59 cases（81.94% ） accompanied with a single organ damage, 13 cases （18. 06%） with two organ damage. Ther onset time of 28 cases was from 5 to 10 days, 7 cases （25.00%） companied with single organ damage, 16 cases（57.14%） with two organ damage and 5 cases（17.86%） with multiple organ damage. The onset time of 18 cases was from 10 to 14 days, 6 cases（33.33% ） accompan/ed with two organ damage, 12 cases（66.67% ） with multiple organ damage. The onset time of 9 cases was over 14 days, 9 cases（100%） accompanied with multiple organ damage. There 63 with onset time of within 5 days were cured （100%）. The cure rate of 31 cases with the onset time of from 5 to 10 days was 96.88%. One case died with a fatality rate 3.12%. The prognosis of 19 cases was favorable and thecurafive rat was 95.00% and a cases died with fatality rate of 5.00% among 20 cases of diagnosis in 11 to 14 days. The prognosis of 10 cases were favorable and the the curative rate was 83.33%and 2 cases died with fatality rae of 16.67% among 12 cases of diagnosis over 14 days. Condusion The chance of number of organ damage, multiple organ damage failure and the death rate were high as the onset longer in patents with tsutsugamushi disease. Early diagnosis and effective treatment were important factor for the clinical prognostic in patents with tsutsugamushi disease.