河北省首次发现恙虫病病例的初步研究

First Report of Tsutsugamushi Disease in Hebei Province: A Preliminary Study

目的 :证实河北省恙虫病的存在。方法 :对可疑病人进行调查、采血 ,用血清学方法检测病人血清抗体并分型。结果 :14例发热病人中的 13例被诊断为恙虫病 ,确诊率为 92 .86 %。患者均为成年人 ,年龄在 32～ 6 9岁之间 ,男性 4例 ,女性 9例。发病时间为 1997年 10月 1～ 2 0日。病人血清OXk抗体阳性率为 10 0 % ,GMT为 1∶92 6 .6 ;恙虫病立克次氏体IgG抗体阳性率为92 .3% ,GMT为 1∶94 1.2 ;IgM抗体阳性率为 84 .6 % ,GMT为 1∶1546 .4。对病人血清标本进行血清学分型 ,证实为恙虫病Gilliam血清型。结论 :河北省太行山区首次被证实有恙虫病病例存在。

Aim: To demonstrate the existence of tsutsugamushi disease in Hebei province. Methods: An investigation was carried out. Blood specimens were taken from the suspicious patients. Serological methods were used to detect antibodies and to determine serological type. Results:Among those 14 suspicious patients, 4 men and 9 women were diagnosed as tsutsugamushi disease . The cases of tsutsugamushi disease aged from 32 to 69 years. The first case attacted on October 1, 1997. And the last one attacted on October 20, 1997. OXk antibody of all the cases was positive , and its geometric mean titer (GMT) was 1∶ 926.6 . Positive rate of Rickettisia tsutsugamushi (Rt) IgG antibody was 92.3 %, and GMT of Rt IgG was 1∶ 941.2 . Positive rate of Rt IgM antibody was 84.6 %, and GMT of Rt IgM was 1∶ 1 546.4 . Serological type was determined to be Rt Gilliam. Conclusion: For the first time, cases of tsutsugamushi disease were discovered in Taihang mountain area of Hebei province. The epidemiological factors and characteristics of tsutsugamushi disease are being studied.