铜陵地区疑似发热伴血小板减少综合征24例临床分析

Suspected severe fever with thrombocytopenia syndrome in Tongling area: Clinical features in 24 cases

目的:分析铜陵地区疑似发热伴血小板减少综合征病例临床特点。方法:回顾收集我院近3年收治的疑似发热伴血小板减少综合征患者临床资料,统计分析所有患者的主要临床表现及相关实验室检查结果。结果:24例疑似SFTS病例中,确诊人感染新型布尼亚病毒病2例;所有疑似病例均有发热,部分病例有畏寒、浅表淋巴结肿大、恶心呕吐、腹泻及肌肉酸痛、黑便、神志淡漠、腹痛、头痛、嗜睡及皮肤瘀点瘀斑、低血压/休克及昏迷等;87.5%的病例有血小板计数减少,75%的病例有白细胞计数减少;24例患者均有肝脏血清生化学指标异常,其中天门冬氨酸转氨酶(AST)水平较丙氨酸转氨酶(ALT)水平升高明显。结论:SFTS病例早期无显著特征性临床表现,易误诊,临床医生需提高认识。

Objective：To analyze the clinical features in patients with suspected severe fever with thrombocytopenia syndrome （ SFTS） prevalent in Tongling area,Anhui,China.Methods：Clinical data were obtained in 24 cases with suspected SFTS undergone diagnosis and treatment in our hospital in the past three years,and reviewed regarding the important clinical manifestations and laboratory findings .Results：Although only 2 were confirmed victims of novel bunyavirus,yet the total 24 cases were commonly characterized by high fever,chill,enlarged superficial lymph nodes,nausea and vomiting,diarrhea,mus-cular soreness,dark stools,haziness,abdominal pain,headache,drowsiness,skin petechiae and ecchymosis,hypotension,coma and shock.Thrombocytope-nia occurred in 87.5%and leucopenia in 75%of the total 24 cases by laboratory detection,who simultaneously had significantly elevated level of aspartate aminotransferase（AST） and alanine transarninase（ALT）.Conclusion：Attention should be given in diagnosis of the SFTS due to its absence of notable clinical manifestations in the early stage to prevent misdiagnosis .