合肥市2003-2007年度流行性脑脊髓膜炎病例临床表现与实验室检测结果分析

Clinical manifestation and analysis of laboratory test results on epidemic cerebrospinal meningitis in 2003 through 2007,Hefei,China

目的对合肥市流行性脑脊髓膜炎(以下简称流脑)临床表现与实验室检测结果进行分析,为临床诊治提供依据。方法对合肥市2003-2007年流脑患者的临床表现与实验室结果进行回顾性分析。结果首发症状以发热+头晕+呕吐,发热+头晕,发热为主,分别占23.6%、12.4%和10.9%。普通型占79.66%,暴发型占19.31%,轻型占1.03%,对其中C群病例分型结果显示普通型占81.73%,暴发型占17.31%,轻型占0.97%,C群和所有病例的临床分型差异无统计学意义(P>0.05)。临床症状主要有发热、呕吐、恶心等,构成比均超过50%,布氏征在所有病例和C群病例的分布有统计学差异(P<0.05);8例出现血白细胞数下降,其中C群流脑占2例,15例出现血中性粒细胞数下降,其中C群流脑占3例;死亡病例有2例出现了血中性粒细胞数下降。结论C群流脑在首发症状、临床分型、临床表现等方面并没有发现严重于所有病例;流脑病例中出现了血白细胞和中性粒细胞数下降的现象,值得关注。

Objective To provide foundation for clinical diagnosis and treatment on the basis of analyzing the clinical manifestation and laboratory test results of epidemic cerebrospinal meningitis.Methods Retrospective analysis for the profile of clinical manifestation and laboratory test of the patients with epidemic cerebrospinal meningitis in Hefei during 2003 through 2007.Results The initial symptoms of patients were fever ＋ dizziness ＋ vomiting simultaneously （23.6%）;fever ＋ dizziness simultaneously（12.4%）;or fever only （10.9%）.Conventional type 79.66 %,fulminating type 19.31% and light type 1.03% respectively for all cases.However,the analysis of the result in serogroup C patients are slightly different：the conventional type 81.73 %;fulminating type 17.31% and light type 0.97% respectively.Difference for clinical classification between serogroup C and all cases were insignificant（P0.05）.The major clinical symptoms were fever,vomiting,nausea,neck stiffness,severe headache,petechia and ecchymosis,and dottiness,Constituent ratio of them accounted for more than 50%.There were significant difference in Brudzinski＇s signs between confirmed cases with serogroup C epidemic cerespinal meningitis and all cases（P0.05）.WBC for 8 cases were under normal level by blood routine test,among which there were 2 cases of serogroup C epidemic cerespinal meningitis.15 cases appeared with dropped Neutrophile granulocyte,among which 3 cases were with confirmed serogroup C of epidemic cerespinal meningitis;with in deceased cases,there were two cases had decreased Neutrophile granulocyte.Conclusion Among cases with serogroup C epidemic cerespinal meningitis,their initial symptoms,clinical classification,clinical manifestation were found no more serious than them in all cases;WBC count and neutrophil count were under normal level,which were deserved to be paid attention.