24例重症恙虫病合并多器官功能不全患者的临床特征

24 Cases of Severe Tropical Typhus Merger and Clinical Features of Pa-tients with Multiple Organ Dysfunction

目的分析该地区重症恙虫病合并多器官功能不全患者的临床特征。方法对宿迁市人民医院2014年8月—2015年8月收治的24例确诊重症恙虫病患者的病例资料进行回顾性分析。分析其临床特点、治疗、预后,并得出结论。结果重症恙虫病患者实验室检查多表现为白细胞(WBC)上升、血小板(PLT)下降,C反应蛋白(CRP)、降钙素原(PCT)、D2-聚体等炎症指标明显上升,患者肝功能转氨酶轻中度升高、心肌酶不同幅度升高,影像学检查可见间质性肺炎、胸腔积液、心包积液、脾大、淋巴结肿大等;阿奇霉素疗效确切,体温多在48 h内正常。结论重症恙虫病是多器官功能障碍综合征的高危人群,器官损伤越多死亡率越高,尽早给予阿奇霉素抗感染及器官功能支持治疗可降低重症恙虫病病死率。

Objective To analyze the region’s severe tropical typhus merger and clinical features of patients with multiple organ dysfunction. Methods Of suqian city people’s hospital in August 2014 to Augnst 2015 were 24 cases of confirmed severe cases of tsutsugamushi disease data were retrospectively analyzed. Analyze the clinical characteristics, treatment and prognosis, and draw conclusions. Results Lab tests in severe tsutsugamushi disease characterized by more white blood cells（WBC）, platelet（PLT）, c-reactive protein（CRP）, calcitonin（PCT） and D2- polymers such as inflammatory index increased significantly, liver function in patients with elevated transaminase mild-to-moderate, myocardial enzyme, different amplitude increases, imaging examination showed interstitial pneumonia, pleural effusion and pericardial effusion, lienal, lymph node enlargement, etc.; Azithromycin curative effect, the body temperature to normal within 48 hours. Conclusion Severe tropical typhus is high-risk groups of multiple organ dysfunction syndrome, organ injury mortality rate is higher, the more early azithromycin resistance to infection and organ function support treatment can obviously reduce severe tsutsugamushi disease mortality.