72例恙虫病临床分析

Clinical analysis of 72 cases of tsutsugamushi disease

目的：分析恙虫病的临床特点，为早期诊断及治疗提供依据。方法通过回顾性分析72例恙虫病患者的临床资料，分析其临床特点。结果所有患者均有发热，发生率为100%；嗜酸性粒细胞比值低于正常者97.2%，其中，嗜酸性粒细胞比值为0者占68.1%，治疗后均可升至正常；伴发肝功能异常者95.8%，均加用护肝药物治疗，其中4例患者5-7 d后复查ALT或AST较前改善不明显甚至有加重；所有患者均选用阿奇霉素或克林霉素治疗，有效率100%。结论恙虫病临床表现多样，嗜酸性粒细胞比值为0以及合并肝功能受损可能对于诊断有一定的意义。阿奇霉素或克林霉素可用于恙虫病的治疗，疗效确切、不良反应少但需注意可能出现的药物性肝损。

Objective To analyze the clinical features of tsutsugamushi disease and provide a basis for early diagnosis and treatmentling with this disease. Methods The clinical data of 72 scrub typhus inpatients in our hospital were analyzed retrospectively and to figure out its clinical features. Results All patients had fever and the incidencerate was 100%. 97.2%of the patients had a eosinophilic granulocyte ratio lower than the normal and 68.1%of them had a eosinophilic granulocyte ratio 0, which could all return to normal after treatment. 95.8%of the patients accompanied with liver dysfunction and had liver protection therapy. ALT or AST did not fall or even rised in 4 cases after the treatment of 5-7 days. All patients were treated with azithromycin or clindamycin and the efficiency was 100%. Conclusion Clinical manifestations of tsutsugamushi disease were comlex. the eosinophilic granulocyte ratio was 0 and accompanied with liver dysfunction may have certain significance for the diagnosis. Azithromycin and clindamycin can be used for the treatment of tsutsugamushi disease, which have curative effect and less adverse reaction except that we should pay attention to the drug-induced liver injury might happen.