42例恙虫病流行及临床特征分析

Analysis of the Epidemiological and Clinical Characteristics of 42 Cases of Scrub Typhus

目的:分析永胜县恙虫病的流行和临床特征,为预防、诊断和治疗羌虫病提供依据。方法:对42例确诊为恙虫病患者的病例资料进行回顾性分析。结果:42例患者分布于9个乡镇,发病高峰为6~9月。男性18例(42.86%),女性24例(57.14%)。患者平均年龄(58.95±15.05)岁,均来自农村。所有病例均有发热。35例(83.33%)患者出现典型焦痂或溃疡。嗜酸性粒细胞降低27例(64.29%),肝功能受损33例(78.57%),心功能受损31例(73.81%),肺部受累12例(28.57%)。42例(100.00%)均临床治愈。结论:恙虫病发病有明显季节性,临床表现复杂多样,可累及多个器官,以急性发热为首发症状,焦痂或溃疡是特征性诊断线索,多西环素治疗效果好。

Objective: To investigate the epidemiological and clinical characteristics of 42 cases of Scrub typhus, and to propose effective measures of its prevention, diagnosis and treatment. Methods: The data of 42 patients diagnosed with Scrub typhus was analyzed retrospectively. Results: 42 patients were distributed in 9 towns, and the incidence peak was from June to September. Of all the patients, 18(42.86%)were male and 24(57.14%)were female. The average age was(58.95±15.05)years, and all patients were from rural areas. Fever occurred in all cases. 35 patients(83.33%)showed typical scab or ulcer. Eosinophils were decreased in 27 cases(64.29%), liver function was impaired in 33 cases(78.57%), heart function was impaired in 31 cases(73.81%), and lung function was impaired in 12 cases(28.57%). All the 42 cases(100%)were cured clinically. Conclusion: Scrub typhus has obvious seasonality, and its clinical manifestations are complex and diverse, involving multiple organs. Acute fever is the first symptom, scab or ulcer is the characteristic diagnostic clue, and doxycycline treatment has good effect.