62例输入性疟疾病原学特点分析

Etiological characteristics of 62 patients with imported malaria

目的分析境外输入性疟疾疟原虫病原学特点。方法对62例北京友谊医院北京热带医学研究所2015年1—12月所确诊的输入性疟疾患者进行疟原虫虫种及感染阶段鉴定,计算红细胞感染率,并分析45例恶性疟患者红细胞感染率与血小板计数的关系。结果 62例患者通过血涂片确诊,恶性疟45例(72.5%),间日疟8例(12.9%),三日疟4例(6.5%),卵形疟5例(8.1%);50例(80.7%)可见环状体,8例(12.9%)可见大滋养体,2例(3.2%)可见裂殖体,2例(3.2%)可见配子体;31例红细胞感染率<2%,8例≥5%。恶性疟患者红细胞感染率越高,血小板计数越低。结论境外输入性疟疾病原学表现复杂,以恶性疟为主。感染疟原虫的定性与定量测定对于临床诊治均具有重要意义。

Objective To analyze the malaria parasites in patients with imported malaria in Beijing. Methods A total of 62 patients diagnosed with imported malaria in Beijing Tropical Medicine Research Institute, Beijing Friendship Hospital, from January to December, 2015, were selected. The species of malaria parasites and infection stages were identified, and erythrocyte infection rate was determined. In addition, the association between erythrocyte infection rate and PLT was analyzed in 45 patients with malignant malaria. Results The human blood smears were applied to confirm the diagnosis of malaria in 62 patients. Forty-five patients（72.5%） were infected with Plasmodium falciparum, 8 patients（12.9%） with P. vivax, 4 patients（6.5%） with P. malariae, and 5 patients（8.1%） with P. ovale. Ring forms of plasmodium stained with Giemsa were detected in 50 patients（80.7%）, trophozoite in 8 patients（12.9%）, schizonts in 2 patients（3.2%）, and gametocytes in 2 patients（3.2%）. Erythrocyte infection rate was less than 2% in 31 patients, and more than 5% in 8 patients. The patients with malignant malaria who had higher erythrocyte infection rate with lower levels of PLT. Conclusions Etiology of imported malaria is complicated, and malignant malaria caused by P. falciparum accounts for the majority. Qualitative and quantitative determination of malaria parasites are of great importance for the diagnosis and treatment of malaria.