塞拉利昂弗里敦地区老年埃博拉病毒病患者临床特点研究

Clinical characteristics of elderly patients with Ebola virus disease in Freetown area, Sierra Leone

目的研究塞拉利昂弗里敦地区老年埃博拉病毒病(Ebola virus disease,EVD)患者的临床特点。方法选取我国解放军援塞医疗队2014年10月—2015年3月收治的老年(>60岁)EVD确诊患者21例(老年组)进行回顾性分析,研究其临床特点。选取同期收治的非老年EVD患者235例(非老年组)作为对照。结果老年组病毒载量与非老年组差异无统计学意义。老年组主要临床表现依次为发热、乏力、纳差、腹痛、头痛、咳嗽、关节痛、恶心呕吐、腹泻、肌肉痛、胸痛和结膜炎。老年组腹痛(85.7%)和精神错乱(23.8%)的发生率均高于非老年组[64.3%(P=0.047)和8.9%(P=0.047)],关节痛(61.9%)的发生率低于非老年组(83.0%)(P=0.018)。老年组病死率(33.3%)与非老年组(39.1%)差异无统计学意义,老年组入院后至死亡的平均死亡时间[(3.0±1.4)d]与非老年组[(2.3±1.7)d]差异亦无统计学意义。结论老年EVD患者临床表现及预后与非老年EVD患者类似,但仍具有其自身特点,这对诊断和治疗具有重要的指导意义。

Objective To investigate clinical characteristics of elderly patients with Ebola virus disease（EVD） in Freetown area, Sierra Leone. Methods Twenty-one elderly EVD patients（more than 60 years old）（elderly group） treated by Chinese PLA medical aid team in Sierra Leone from October 2014 to March 2015 were analyzed retrospectively to study their clinical characteristics. Totally 235 non-elderly EVD patients（non-elderly group） treated in the same period were selected as controls. Results Ebola viral load was not significantly different between elderly group and non-elderly group. The main clinical manifestations of elderly EVD patients were fever, fatigue, anorexia, abdominal pain, headache, cough, joint pain, nausea and vomiting, diarrhea, muscle pain, chest pain and conjunctivitis. The incidence rates of abdominal pain（85.7%） and mental confusion（23.8%） of elderly group were higher than those of non-elderly group（64.3%, P=0.047; 8.9%, P=0.047）, while the incidence rate of joint pain of elderly group（61.9%） were lower than that of non-elderly group（83.0%）（P=0.018）. The mortality rate of elderly group（33.3%） was not significantly different from that of non-elderly group（39.1%）. The mean death time after hospitalization between elderly group（3.0±1.4 days） and non-elderly group（2.3±1.7 days） was not significantly different. Conclusions The clinical manifestations and prognosis of elderly EVD patients are similar as those of non-elderly EVD patients, but those of elderly EVD patients still have their own characteristics, which is of important significance in diagnosis and treatment of EVD.