蓬莱市人民医院发热伴血小板减少综合征53例临床分析

Clinical analysis of 53 patients with severe fever with thrombocytopenia syndrome in People 's Hospital of Penglai city

目的研究发热伴血小板减少综合征的流行病学和临床特点,以提高对该病的认识。方法对蓬莱市人民医院2011—2013年收治的53例发热伴血小板减少综合征的临床资料进行回顾性分析。结果病例呈高度散发,以农民(94.34%)为主,聚集性发病14例,6—9月为发病高峰。所有患者均发热,主要症状为乏力、全身酸痛、纳差和恶心,主要体征为腹股沟淋巴结肿大和触痛(64.15%)、舌体及肢体震颤(58.49%)。实验室检查结果为发病早期WBC下降(94.34%)、PLT下降(88.68%)和嗜酸性粒细胞比例降低(98.11%),ALT、AST、乳酸脱氢酶、肌酸激酶同工酶和空腹血糖升高以及蛋白尿。治愈39例,死亡14例(26.42%)。年龄偏大、既往有基础疾病、发病后未及时诊治以及有神经系统症状患者病情较重,病死率较高。结论早发现、早诊断、早治疗,同时防止并发症,加强消毒隔离和防护措施,可降低病死率。

Objective To investigate the prevalence and clinical features of severe fever with thrombocytopenia syndrome（SFTS） so as to improve the understanding of the disease. Methods Clinical data of 53 patients with SFTS treated in the People＇s Hospital of Penglai from 2011 to 2013 were analyzed retrospectively. Results SFTS was highly distributed with peak incidence from June to September. Peasants accounted for the largest proportion（94.34%）, and spatial aggregation was found in 14 patients. All patients had fever, the main symptoms included fatigue, body pain, anorexia and nausea, and the main signs included inguinal lymph node enlargement and tenderness（64.15%）, and the tongue and limbs tremor（58.49%）. Laboratory examination results showed that at the early stage of the onset, WBC（94.34%）, PLT（88.68%） and eosinophilic granulocyte ratio（98.11%） decreased, ALT, AST, LDH, CK-MB and fasting blood glucose elevated, and proteinuria occurred. Thirty-nine patients were cured, and 14（26.42%） died. Patients with older age, presence of underlying diseases, failure to receive timely diagnosis and treatment after onset, and presence of respiratory symptoms have more severer condition, and higher mortality. Conclusions Early detection, early diagnosis and early treatment, prevention and treatment of complications, and strengthening the disinfection, isolation and protection measures, can help reduce the case fatality rate.