川北地区35例流行性乙型脑炎的流行病学及临床特征分析

Epidemiological and clinical analysis of 35 cases of Japanese encephalitis

目的:分析川北地区35例流行性乙型脑炎的流行病学及临床资料,了解该地区乙脑的临床特征。方法:收集川北医学院附属医院2016年至2017年收治的流行性乙型脑炎患者(共35例)的流行病学及临床资料,并对该资料进行回顾性分析。结果:男∶女=1.5∶1,所有患者均在7月和8月发病,88.57%患者来自农村,65.71%患者未进行乙脑疫苗预防接种,平均年龄(4.7±4.19)岁,10岁以下患者33例(94.29%),其中2~6岁儿童20例(57.14%);患者多以发热、抽搐、意识障碍等为临床表现,其中轻型5例(14.29%),普通型10例(28.57%),重型13例(37.14%),极重型7例(20%),治愈14例(40%),有效10例(28.57%),无效/死亡5例(14.29%),转院/放弃治疗6例(17.14%)。结论:川北地区乙脑发病有严格季节性,以散发病例为主,10岁以下儿童发病多见,男女发病无差异,乙脑特异性抗体检测可协助早期诊断,控制好高热、抽搐及呼吸衰竭可以有效降低乙脑的死亡率。

Objective： To analyze the epidemiological and clinical data of 35 cases of Japanese encephalitis（ JE） and understand its clinical characteristics. Methods： Collect and analyzed retrospectively epidemiological and clinical data of 35 patients with JE admitted in the affiliated hospital of North Sichuan Medical College from 2016 to 2017. Results： Male： Female = 1. 5∶ 1,all patients were onset at 7 - 8 months,88. 57% patients from rural areas,65. 71% patients with no JE vaccination,mean age 4. 7 ± 4. 19 years,33 cases（ 94. 29%） were under 10 years old,including 20 cases（ 57. 14%） between 2 and 6 years old. Patients with fever,convulsions,consciousness and other clinical manifestations,including 5 cases of mild（ 14. 29%）,10 cases of common type（ 28. 57%）,13 cases of severe（ 37. 14%）,very severe in 7 cases（ 20%）,14 cases were cured（ 40%）,effective in 10 cases（ 28. 57%）,5 cases of invalid/death（ 14. 29%）,referral/give up the treatment of 6 cases（ 17. 14%）. Conclusion： The incidence of JE in North Sichuan area is strictly seasonal,with sporadic cases,children under 10 years old are more common and there is no difference in incidence between males and females. The detection of JE antibody can assist in early diagnosis,It can effectively reduce the mortality of JE by controling high fever,convulsions and respiratory failure.