妊娠合并恙虫病21例临床分析

Clinical analysis of 21 pregnant women with tsutsugamushi disease

目的探讨妊娠合并恙虫病的临床特征,为早期诊断及治疗提供依据。方法回顾性分析21例妊娠合并恙虫病的临床资料,包括症状和体征、实验室检查、治疗及转归。结果 21例恙虫病为中、晚期妊娠患者。均有发热表现,出现焦痂16例、皮疹4例、淋巴结肿大5例、肝脾大2例。外斐试验变形杆菌OXk凝集反应阳性6例。患者早产7例,宫内死胎2例。患者可出现肝脏、肾脏、肺脏、心脏等多器官功能损伤。给予所有患者阿奇霉素治疗,治愈率为100%,无明显不良反应。结论妊娠合并恙虫病临床表现复杂,常出现多器官损伤,阿奇霉素治疗安全有效。

Objective To investigate the clinical characteristics of tsutsugamnshi disease in pregnant patients, so as to provide evidence for early diagnosis and treatment. Methods The clinical data, including signs and symptoms, laboratory findings, treatment and outcome of 21 pregnant women with tsutsugamushi disease were analyzed retrospectively. Results The 21 patients with tsutsugamushi disease were in middle and late stage of pregnancy. Fever was present in all the patients, eschar in 16 patients, rash in 4 patients,enlarged lymph node in 5 patients and liver and spleen enlargement in 2 patients. The Weil-Felix OXk test was positive in 6 patients.Preterm delivery occurred in 7 patients, and intrauterine demise in 2 patients. The disease was often complicated by liver, kidney, lung and heart injury and other multiple organ injury. All patients were given azithromycin treatment with the curative rate of 100%, and no significant adverse reactions were found. Conclusions The clinical manifestations of pregnant women with tsutsugamushi disease were complex, and the patients often present with multiple organ injury. Azithromycin treatment is safe and effective.