发热伴血小板减少综合征“重灾区”病例临床及流行病学特征分析

Analysis of clinical and epidemiological characteristics of severe fever with thrombocytopenia syndrome in high affected area

目的：探讨发热伴血小板减少综合征在“重灾区”内的临床特征和流行病学特征。方法：采用流行病学个案调查和描述性分析的方法, 对比研究了发热伴血小板减少综合征“重灾区”--河南省信阳市境内近10年发生的确诊病例、疑似病例的病历资料。结果：发热伴血小板减少综合征疫情主要发生在信阳市西南部的山地、丘陵地带或水库周边地区，发病人群以50岁以上中老年为主（97.63%）、女性多于男性，6 - 7月为发病高峰（63.82%）。所有病例均有发热,体温最低37.6℃,最高40.7℃,平均39.3℃,且发热为主要首发症状，大部分病例有乏力（97.36%）、食欲减退（92.32%）、畏寒（90.82%）等非特异性症状。临床表现为发热伴白细胞和血小板减少,白细胞、血小板进行性减少可持续到发病后14 - 15 d,但后者持续时间更长；未发现人传人现象。结论：发热伴血小板减少综合征“重灾区”内的临床与流行病学特征与其他地区存在差异,其病变机制尚有待于进一步研究。

Objective： To study the clinical and epidemiological characteristics of severe fever with thrombocytopenia syndrome（SFTS） in the high area affected. Methods： A descriptive epidemiological method combined with individual case investigation was applied to analyze the dada of epidemiology, diagnosis and treatment of clinically diagnosed as well as suspicious patients with SFTS occurred in Xinyang, Henan province during recent 10 years. Results： SFTS was to endemic in Southwest Xinyang. Most cases were more than 50 years old and resided in mountainous or hilly region or around reservoir areas（97.63%） and 63.82% of the diseases occurred in June and July. The patients all experienced fever with a body temperature ranging from 37.6℃ to 40.7℃, which was the main on-set symptom. Meanwhile, most patients also experienced fatigue（97.36%）, anorexia（92.32%）, chill（90.82%） and other non-specific symptoms.The major clinical features were fever accomparied, thrombocytopenia and leucocytopenia which could last 14-15 days, or even longer for thrombocytopenia. Person to person transmission was not found. Conclusion： There are differences in clinical and epidemiological characteristics of SFTS in Xinyang compared from other provinces, and further study needs to be done.