新疆输入性非洲恶性疟和三日疟4例报告

Four cases of imported African falciparum malaria and quartan malaria infection in Xinjiang

本文报道新疆某院2018年收治的输入性2例恶性疟和2例三日疟患者的临床表现、实验室诊断特点、治疗、预防情况。4例患者均为外派非洲喀麦隆、利比里亚、尼日利亚和南苏丹务工人员,均有蚊虫叮咬史,回国返疆前后出现发热、寒战、头痛、烦躁等症状入院。实验室快速法检测疟原虫阳性3例,阴性1例;薄血膜涂片镜检可见恶性疟和三日疟不同阶段环状体、裂殖体、配子体等多种形态特点;炎性细胞因子检测:C-反应蛋白增高,L-6、IL-10、IFN-γ、TNF-α均明显增高至数倍,血沉加快,而血象变化不大。用蒿甲醚80 mg肌肉注射,1次/d,或以青蒿琥酯静脉注射120 mg,首次剂量加倍,连续7 d方案治疗,7 d疟原虫转阴1例,1例转阴时间较长为16 d,4例均治愈,随访2个月,均无复燃。

This paper reports the clinical history,laboratory diagnosis,treatment and prevention of two patients with falciparum malaria and two patients with quartan malaria in a hospital in Xinjiang.Four patients were sent to work in Cameroon,C?te d'Ivoire and Nigeria in 2018.They all had a history of mosquito bites.They were admitted to the hospital before and after returning to China for fever,chills,headache,and irritability.Laboratory rapid detection of Plasmodium positive in 3 cases,negative in 1 case;thin blood film smear microscopic examination showed different morphological characteristics of morphological,schizont,and gametophytic bodies in different stages of falciparum malaria and quartan malaria;the detection of inflammatory cytokines found C-reactive protein increased,IL-6,IL-10,IFN-γ,TNF-α were significantly increased several times,ESR accelerated,and blood changes were not significant.After 80 mg of artemether was intramusculally injected once a day,or 120 mg of artesunate was intravenously injected once a day,the first dose was doubled,and the treatment was continued for 7 days.One patient became negative after 7 days,and one patient remained negative for 16 days.All 4 patients were cured.The patients were followed up for 2 months without recurrence.