北京市37例输入性登革热的临床特点及诊断思路分析

Elementary analysis of clinical diagnosis and treatments for 37 imported dengue fever cases in Beijing

目的回顾性分析北京地区输入性登革热患者的诊治经过、临床特征，探讨早期诊断方法。方法统计北京地坛医院（以下简称我院）2001-2016年收治的登革热住院患者37例，分析患者诊治经过、流行病学史、临床症状、血常规、登革热抗体等指标，形成登革热规范诊治思路。结果输入性登革热37例，以男性25例，女性12例，均无严重基础疾病，合并疟疾3例，均可追溯到明确的流行病学史，均在病前2周内在登革热流行区有停留史。患者到我院就诊时间为病程2～12d，平均5．5d。半数以上患者出现典型症状体征，所有患者血登革病毒特异性IgM阳性。治疗主要给予保肝、对症支持治疗，预后好。结论在登革热非流行区，接诊医师应对本病保持警惕，详细询问流行病学史，全面查体，及早行血登革病毒特异性IgM或登革热抗原（NS1）检测及病毒核酸检测，进行早期诊断，并给予及时治疗。

Objective To review the diagnosis, treatments and clinical features of the imported dengue fever cases in Beijing, so as to explore the earlier-diagnosis methods. Methods Epidemiological history, clinical symptoms, results of routine blood tests and dengue antibodies tests as well as case diagnosis and treatments of 37 dengue fever patients admitted in Beijing Ditan Hospital were collected for the analysis of the clinical diagnosis and treatments in imported dengue fever cases. Results A total of 25 male and 12 female patients without severe underlying diseases were enrolled in the study, including 3 cases of coinfection with malaria based on their epidemiology history. Epidemiologic data indicated that 2 weeks of residence history in dengue fever epidemic area were found in all 37 cases, times of hospital visiting ranged from the 2nd day to the 12th day in course of disease with a mean value of 5.5 days. More than half of the patients had symptoms or signs. Laboratory tests indicated that all patients were positive for specific IgM against dengue virus. The main treatments included liver protection, symptomatic treatment, and all of patients had indicated good prognosis. Conclusions In the non-epidemic area of dengue fever, the physicians should increase the awareness of the disease, and combine epidemiological history,comprehensive examination and early blood dengue virus specific IgM antigen, or dengue fever （NS1） virus nucleic acid testing for early diagnosis and treatments.