以嗜酸粒细胞减少为主要特征的117例恙虫病报告

The report of reduction of eosinophil in the 117 patients with scrub typhus

目的 报告恙虫病患者嗜酸粒细胞减少现象.方法 对界首市人民医院和临泉县人民医院2012年8月至12月收治的117例恙虫病患者的临床特征进行回顾性分析,另外选取健康体格检查者60名作为健康对照组,对照研究恙虫病患者嗜酸粒细胞的变化.计量资料比较采用t检验,计数资料比较采用x2检验.结果 嗜酸粒细胞减少在恙虫病患者的发生率为96.6％,居各种实验室检查异常发生率的第1位.治疗前恙虫病组嗜酸粒细胞减少率为96.6％（113/117）,嗜酸粒细胞计数为（0.016±0.009）×109/L,而健康对照组分别为8.3％（5/60）和（0.085±0.025）×109/L,差异均有统计学意义（x2 =138.990 4,P＜0.01;t=15.678 3,P＜0.01）.共有65例患者在治疗后4～9 d复查血常规,嗜酸粒细胞减少率下降为23.19,嗜酸粒细胞计数升高为（0.040±0.010）×109/L,与治疗前比较,差异均有统计学意义（x2=108.191 2,P＜0.01;t=2.641 2,P＜0.05）.结论 嗜酸粒细胞减少是恙虫病患者的重要临床特征,可作为恙虫病诊断的重要线索之一.

Objective To report the reduction of eosinophil in patients with scrub typhus.Methods The clinical features of 117 patients with scrub typhus from August 2012 to December 2012 were retrospectively analyzed.Another 60 healthy control subjects were chosen as healthy controls from Jieshou People＇s Hospital.The change of the eosinophil count or percentage was compared between patients and healthy control subjects.Statistical analyses were performed by t test and enumeration date was compared using x2 test.Results The incidence of eosinophil reduction （count or percentage） in patients with scrub typhus was 96.6％ （113/117）,which accounted for the first place in various auxiliary examination.The incidence rate of eosinophil count or percentage reduction was 96.6 ％ （113/117） before treatment,with the eosinophil count of （0.016±0.009） × 109/L.The incidence rate in healthy control group was 8.3％ （5/60） with the count of （0.085± 0.025） × 109/L.The differences between the two groups were statistically different （x2 =138.990 4,P＜0.01 ;t=15.678 3,P＜0.01）.A total of 65 patients examined blood routine after 4-9 days of treatment.After treatment,the incidence of eosinophil reduction in scrub typhus group was 23.1％,and the eosinophil count increase to （0.040±0.010） × 109/L.The difference reached statistical significance compared with the incidence rate and cell count pretreatment （x2 =108.191 2,P＜0.01 ;t=2.641 2,P＜0.05）.Conclusion Reduction of eosinophils in patients with scrub typhus is an important clinical characteristics,which can be used as an important clue for the diagnosis of scrub typhus.