麻疹32例临床分析

Clinical Analysis of 32 Measles Cases

目的探讨麻疹的流行病学变化及临床特点。方法回顾性分析房县人民医院2010年1月至8月收治的32例麻疹住院患者临床资料。结果婴幼儿及学龄前儿童25例(78.1%),成人7例(21.9%),麻疹发病高峰时间集中在6～8月份,乡村人群病例较高(81.3%),无疫苗接种者居多(81.3%),18.8%患者有明确麻疹接触史;临床表现包括发热、上呼吸道卡他症状、早期出现麻疹黏膜斑、发热3～5d后出现典型皮疹;75.0%患者肝功能异常,84.4%心肌酶升高,84.4%测检麻疹抗体IgM阳性;并发症包括肺部感染、喉炎、腹泻及脑炎;患者经抗病毒、对症及防治并发症等治疗均痊愈。结论麻疹发病以婴幼儿为主,发病季节后移,乡村发病率较高,临床表现多不典型,预后较好,麻疹IgM仍是实验室诊断的主要指标。加强卫生宣传和对易感人群计划免疫是控制麻疹流行的有效措施。

Objective Explore the epidemiological change and clinical features of measles.Methods Clinical data of 32 hospitalized patients with measles from January 2010 to August were analyzed retrospectively.Results The total patients,infants and preschool children in 25 cases（78.1%）,adult in 7 cases（21.9%）.Measles incidence focused on June to August.Rural population-based and no vaccination cases were more（81.3%）,18.8% patients had a clear exposure history to measles.Clinical manifestations included fever,upper respiratory catarrhal symptoms,Koplik spots,typically rash appearing after fever 3 to 5 days.75.0% patients with abnormal liver function,84.4% patients with elevated myocardial enzymes increase,84.4% patients with measles antibody IgM positive.Measles complications included lung infection,laryngitis,diarrhea and encephalitis.By anti-virus,symptomatic treatment and prevent complications,all patient were up to clinical cure.Conclusions Measles mainly happen in infants and young children,its onset of seasonal shift after,the prevalence is higher in country,clinical features is atypical,measles IgM is still the main target of laboratory diagnosis.Strengthening health promotion and immunization of vulnerable populations is an effective measure to control measles.