绵阳市45例输入性疟疾流行病学特征及临床分析

Epidemiological and clinical analysis of 45 patients with imported malaria in Mianyang

目的探讨绵阳市输入性疟疾的流行病学和临床特征，为该病的诊断和治疗提供指导。方法对绵阳市2011-2013年收治住院的45例输入性疟疾患者的流行病学和临床资料进行回顾性分析。结果45例输入性疟疾病例均为男性，年龄为（35．64±10．03）岁。其中，间日疟23例（51．11％），恶性疟22例（48．89％）；有19例（42．22％）在疟疾流行区曾经感染疟疾。所有病例均发热，29例（64．44％）在热退后有大汗，32例（71．11％）有寒战。此外还伴有肌肉酸痛40例（88．89％）、恶心呕吐8例（17．78％）、咳嗽12例（26．67％）、腹痛腹泻9例（20%）、贫血16例（35．56％）、黄疸3例（6．67％）和肝脾肿大19例（42．22％）。45例病例中，31例（68．87％）血小板降低、16例（35．56％）血红蛋白降低，26例（57．78％）肝脏酶学升高、3例（6．67％）总胆红素升高，1例（2．22％）尿素氮和肌酐升高。B超查见肝脏肿大者11例（24．44％）。脾脏肿大者19例（42．22％）。经病原学治疗和对症治疗后，所有病例均在1-2周内治愈出院．无死亡病例。结论输入性疟疾病例有流行病学史，临床表现复杂、并发症多，早期规范的抗疟治疗效果好。

Objective To explore the clinical manifestations and epidemiologieal characteristics of the imported malaria in Mianyang, and to guide diagnosis and treatment. Methods The epidemiologieal and clinical data of 45 patients with imported malaria admitted by Mianyang 404 hospital from 2011 to 2013 were retrospectively analyzed. Results All the patients were male whose average age was （35.64 ±10.03） years old. 23 patients were infected with P. vivax and the others were infected with P. falciparum. 19 of 45 patients had past history of malaria in endemic areas. All the patients had fever. 64.44% of the patients had sweating after fever subsided. 71.11% of the patients had shiver. Of the 45 patients , muscle soreness was found in 88.89% cases. 17.78% of the patients had nausea and vomiting, 26.67% had cough, 20% had abdominal pain and diarrhea, 35.56% had anemia, 6.67% had jaundice and 42.22% had enlarged liver and spleen platelet counting decreased in 68.7% cases while hemoglobin decreased in 35.56% cases. Hyperaminotransferase and total bilirubin elevated in 57.78% and 6.67% cases respectively. Urea nitrogen and ereatinine elevated in 2.22% cases. Abdominal ultrasound graphic showed enlarged liver and spleen in 24.44% and 42.22% cases respectively. All the cases were cured in 1 to 2 weeks and nobody died. Conclusion Imported malaria patients have complicated clinical manifestation and variety of complications with the history of epidemiology. The early specific antimalarial treatment may achieve good effect.