风疹患者408例临床流行病学和临床特征回顾性分析

Retrospective analysis of clinical epidemiology and clinical features of 408 patients with rubella

目的研究风疹患者的临床流行病学和临床特征。方法对哈尔滨医科大学附属第二医院2002年至2004年收治风疹患者的临床流行病学、临床表现及实验室检查资料进行回顾性分析。阳性率比较采用Z。检验。结果408例风疹患者中，90．0％有与风疹患者接触史；75．5％为学生。71．1％患者发热，100．0％皮疹，90．0％淋巴结肿大。10．3％患者肝功能异常，11．8％心肌酶学升高，60．0％wBC减少，70．1％淋巴细胞增多。成人组（125例）与儿童组（283例）患者相比，1～2d出疹的患者比例分别为102和264例（x^2=12．823，P〈0．01），1～3d皮疹消退者分别为43和129例（x^2=4．447，P=0．035），散在性皮疹分别为108和263例（x^2=4．487，p=0．034），出现淡红色皮疹的分别为99和247例（x^2=4．392，P=0．036），符合由面部至躯干出疹顺序的分别为104和256例（x^2=4．402，P=0．036）；PLT减少发生率分别为10．4％和2．5％（x2=11．686，P〈0．01），肝功能异常率分别为17．6％和7．1％（x^2=10．416，P〈0．01），心肌酶异常率分别为20．0％和8．1％（x^2=11．774，P〈0．01）；合并支气管肺炎患者比例分别为0．8％和6．7％（x^2=6．505，P=0．011），合并肝炎的分别为17．6％和7．1％（x^2=7．117，P=0．008），合并心肌炎的分别为18．4％和7．1％（x^2=11．811，P〈0．01），合并关节炎的分别为12．0％和2．8％（x^2=13．715，P〈0．01）。结论成人与儿童风疹患者相比，全身症状重，皮疹不典型病例多，肝脏和心脏酶谱异常的比例高，应引起重视。

Objective To investigate the clinical epidemiology and clinical features of patients with rubella. Methods Data of clinical epidemiology, clinical manifestations, laboratory findings of patients with rubella hospitalized in Second Affiliated Hospital of Harbin Medical University from 2002 to 2004 were retrospectively analyzed. Positive rates were analyzed using chi square test. Results Of the 408 patients with rubella, 90.0% had histories of contacting with patients with rubella, and 75.5% were students. The common clinical manifestations were fever （71.1%）, rash （100.0%）, lymphadenectasis （90.0% ）. Laboratory findings were liver dysfunction （10.3 % ）, myocardial enzyme abnormality （11. 8%）, WBC decrease （60.0%） and lymphocythemia （70. 1%）. The differences between adult group （n= 125） and children group （n= 283） were compared. The numbers of patients with eruption time within 1--2 days were 102 and 264, respectively （x^2=12. 823, P〈0.01）; those with deflorescence time within 1--3 days were 43 and 129, respectively （x^2=4.447, P=0.035）; those with sporadic rash were 108 and 263, respectively （x^2 = 4. 487, P = 0. 034）, those with erythroic rash were 99 and 247, respectively （X^2 =4. 392, P=0. 036）; those with eruption order of head to trunk were 104 and 256, respectively （x^2 = 4. 402, P = 0. 036） ; those with thrombocytopenia were 10.4 % and 2.5 %, respectively （x^2 = 11. 686, P〈 0. 01） ; those with liver dysfunction were 17.6 % and 7.1%, respectively （x^2 = 10. 416, P〈0. 01） ; those with myocardial enzyme abnormality were 20.0 % and 8.1%, respectively （x^2 = 11. 774, P〈0. 01）, those complicated with broncho pneumonia were 0. 8% and 6.7 %, respectively （x^2= 6. 505, P=0. 011）; those complicated with hepatitis were 17.6 % and 7.1%, respectively （X^2 = 7. 117, P = 0. 008）; those complicated with myocarditis were 18.4% and 7.1%, respectively （x^2 = 11. 811, P〈 0. 01） and those complicated with arthritis were 12.0% and 2.8%, respectively （x^2= 13. 715, P〈 0. 01）. Conclusions Compared with children patients with rubella, the constitutional symptoms of adult patients are more severe, and the proportion of liver and myocardial enzyme abnormality is higher, which should be paid more attention.