2014～2017年山东省泰安地区输入性疟疾患者临床及实验室相关指标分析

Analysis of Clinical and Laboratory Related Indicators of Imported Malaria Patients in Tai'an Area of Shandong from 2014 to 2017

目的分析2014～2017年山东泰安地区输入性疟疾患者临床及实验室相关指标特征,以提高对输入性疟疾的诊治水平。方法回顾性分析泰安市中心医院2014～2017年58例输入性疟疾患者的临床资料,对患者体征、血细胞检测、肝功能进行统计分析。结果58例患者以发热为首发症状者最多,占82.8%;感染疟原虫类型以恶性疟居多,为56.90%;血细胞检测中,疟疾组白细胞计数(WBC)和中性粒细胞百分比(N%)均高于对照组且差异具有统计学意义(WBC:t=5.371,P<0.05,N%:χ~2=9.592,P<0.05),血小板(PLT)计数低于对照组且差异具有统计学意义(t=7.239,P<0.05),恶性疟患者血小板(PLT)计数低于其他三种疟疾患者,且差异均具有统计学意义(q=4.221～6.778,均P<0.05),三日疟患者白细胞计数(WBC)和中性粒细胞百分比(N%)均低于其他三种疟疾患者,且差异具有统计学意义(WBC:q=3.523～6.818,均P<0.05,N%:χ~2=58.19～63.23,均P<0.05);肝功能检查中,疟疾组患者谷氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBIL)和直接胆红素(DBIL)均高于正常对照组,且差异有统计学意义(t=2.131～8.922,均P<0.05),恶性疟患者TBIL高于三日疟,且差异具有统计学意义(q=4.983,P<0.05);疟疾组患者经治疗后,PLT和AST变化最为明显,患者PLT逐渐上升,AST逐渐下降,在出院前可恢复正常。结论输入性疟疾患者实验室指标有明显特点,且不同类型疟原虫的感染实验室指标有差异,在工作中应加以重视,提高疟疾的诊治水平。

Objective To analyze the clinical and laboratory related indicators of imported malaria patients in Tai＇an of Shan- dong from 2014 to 2017, and improved the diagnosis and treatment of imported malaria. Methods The clinical data of 58 pa tients with imported malaria in Tai＇ an Central Hospital from 2014 to 2017 were retrospectively analyzed. The patients＇ physical signs, blood routine and liver function were statistically analyzed. Results Among the 58 patients, fever was the first symptom, accounting for 82.8%%0; Plasmodium was the most common type of falciparum malaria, accounting for 56.90% ;blood routine examination, white blood cell count （WBC） and neutrophil percentage （N%） were higher than the 0 9 control group significantly （WBC： t 5. 371, p〈0.05 ,N%：χ^2=9. 592, p〈0.05）, and the platelet （PLT） count was lower than the control group significantly （t=7. 239, p〈0.05）. The platelet count （PLT） of patients with falciparum malaria was significantly lower than that of the other three malaria patients （q=4. 221%6. 778 ,all p〈0.05）. The white blood cell count （WBC） and the percentage of neutrophils （N%%0） of patients with malaria were significantly lower than those of the other three malaria patients （WBC ： q= 3.523 % 6.818, all p〈 0.05, N % ： χ^2= 58.19 % 63.23, all p〈 0.05）. In the liver function test, alanine aminotransferase （ALT）, aspartate aminotransferase （AST）, total bilirubin （TBIL） and direct bilirubin （DBIL） in the malaria groups were significantly higher than the normal control group （t=2. 13148. 922, all p〈0.05）. The TBIL of malaria patients were higher than that of Plasmodium vivax, and the difference was statistically significant （q=4. 983, p〈 0.05）. After treatment,the changes of PLT and AST were the most obvious in patients with malaria. After treatment,PLT gradually increased and AST gradually decreased. Conclusion The laboratory indicators of patients with imported malaria had obvious characteristics,and there were differences in laboratory indicators of infection of different types of malaria parasites. Attention should be paid to the work to improve the diagnosis and treatment of malaria.