某战区部分驻地秋冬型恙虫病临床与流行病学特征分析

Analysis of clinical features and prevalence characters of autumn-winter type Tsutsugamushi disease in part of a specific military region

目的了解某战区驻地恙虫病的临床与流行病学特征,为指导部队做好防治工作提供科学依据。方法选择临床确诊恙虫病患者进行个案调查,并填写流行病学调查表。同时采集患者静脉血液,分离血清,做血清学检验,并结合课题组的文献和相关资料进行整理统计分析。结果某战区部分驻地恙虫病的临床与流行病学特征与我国南方的夏季型不尽相同,主要具有以下特点：①患者临床表现以发热和全身中毒症状为主,溃疡焦痂约占54.81%;②合并器官损害发生率为45.93%,其中有多个器官损害（multi-organs lesion,MOL）者占26.67%;③流行季节9~12月,占发病数85.19%（115/135）以上,属秋冬型;④病例以散发为主,偶见局部小暴发;⑤患者以青壮年农民居多,占84.44%;⑥流行血清型以Gilliam为主,并可能伴有其他型混合感染。结论基本模清某战区部分驻地秋冬型恙虫病临床与流行病学特征,提示当地军民应重视本病的防治工作。

Objective To understand the clinical and prevalence characters of the autumn-winter type Tsutsugamushi disease in a specific military region,so as to offer scientific information for Tsutsugamushi disease preventing.Method Case study was applied upon the diagnosed Tsutsugamushi disease patients,and filled up the epidemiology tables.Collecting the venous blood from patients,separated the serum and detected it,arrangement,statistics and analysis the data of related papers.Results Clinical feature and prevalence character of Tsutsugamushi disease in the selected military region were different from the summer-type Tsutsugamushi disease in South China,the main characters were as follows.a）The main symptoms of the patients were fever and systematic poisoning,with eschar and ulceration was accounted for 54.81%.b）The incidence rate of multi-organ injury was 45.93%.MOL was accounted for 26.67%.c）The epidemic season of the disease was from September to October,and accounted for 85%（115 of 135）,it belong to autumn-winter type.d）The case was mainly sporadic,with only few local break outs.e）Most of the patients were adult peasants（84.44%）.f）The main serum type was the Gilliam,possibly combined with other types.Conclusions The clinical and epidemiological characters of autumn-winter type Tsutsugamushi disease in the selected military region were basically determined.It is suggested that local troops as well as residents must pay sufficient attention to the prevention of this disease.