小儿恙虫病35例临床特征分析

Analysis of clinical feature of 35 infant tsutsugamushi disease paptients

目的探讨小儿恙虫病临床特征并对本病的治疗效果进行分析。方法对海南省人民医院2008年1月至2010年12月收住的35例恙虫病的临床资料进行回顾性分析。结果 35例患儿均有发热,均发现有焦痂或溃疡;外周血象<4.0×109/L以下者9例,血红蛋白<90g/L者26例,血小板<100×109/L者23例;变形杆菌OXK凝集效价阳性率54.29%;肝功能损伤33例;心肌损伤11例;并发脑炎7例。治疗效果:痊愈31例,好转3例,死亡1例。结论恙虫病可累及肝、肺、心脏、血液、神经等器官、系统,外斐反应阳性率不高,作为诊断或排除本病的可靠性有限。结合流行病学史及焦痂或特异性溃疡是确诊恙虫病的最重要依据。

Objective To investigate the clinical features of infant tsutsugamushi disease cases. Methods The clinical data of 35 infant tsutsugamushi disease patients in Hainan Provincial People＇s Hospital from January 2008 to December 2010 were retrospectively analyzed. Results All the 35 infant patients had fever with eschar or ulcer. Routine blood examination showed leukocyte was 〈4.0 x 109 / L or less in nine cases, hemoglobin 〈90g / L in 26 cases, platelets 〈100 x 109 / L in 23 cases ; The agglutination titer positive rate of the proteus OXK was 54.29%; liver dysfunction was observed in 33 cases, myocardial injury occurred toll cases and 7 cases complicated with encephalitis. Thirty-one cases cured, 3 improved and 1 died. Conclusion Tsutsugamushi disease can affect the liver, lung, heart, blood, nerves and other organs and systems. The positive rate of Weil-Felix test is not high, so the reliability of the diagnosis is limited. Epidemlological history and eschar or ulcer can offer essential evidence for diagnosis of tsutsugamushi disease.