人埃里克体病36例临床分析

Clinical Analysis of 36 Patients with Human Ehrlichioses

目的探讨人埃里克体病的临床特征、诊断和治疗。方法回顾性调查2009年4月至10月武汉市协和医院感染性疾病科收治的36例人埃里克体病病例,分析人埃里克体病的流行病学、临床表现、诊断和治疗。结果 36例患者绝大多数来自农村,散发发病,主要表现为发热、肌肉震颤、出血以及多器官受损。其中有21例出现了严重并发症,有28例患者在发病早期曾应用激素治疗,其中13例继发了肺部感染,病死率达到25%。结论人埃里克体病的实验室确诊困难,主要依靠临床诊断,需要提高临床医生对该疾病的认知度,减少误诊率,早期适当治疗可大大提高治愈率。

Objective To study the clinical feature,diagnosis,therapy of human ehrlichioses（HE）.Methods Thirty-six patients with HE admitted at Union Hospital from April to October in 2009 were retrospectively reviewed.Epidemiology,clinical manifestation,diagnosis and therapy of HE were analyzed.Results Most of 36 patients with HE were from countryside with sporadic occurrence and manifested with fever,muscle fasciculation,hemorrhage and multiple organ damage.Twenty-one patients suffered from severe complications.Twenty-eight patients with HE received hormonal therapy in the early stage.Thirteen patients were associated with secondary pulmonary infection and the mortality was 25%.Conclusion The definite diagnosis of HE is difficult in laboratory and mainly diagnosed clinically.The reduction of misdiagnosis rate and early treatment for HE can greatly increase the curative rate.