皖南地区10例输入性登革热流行病学及临床特征分析

Epidemiological and clinical characteristics of 10 cases of imported dengue fever in southern Anhui province

目的:探讨皖南地区输入性登革热(dengue fever,DF)的流行病学及临床特征,以提高临床对输入性DF的早期识别和诊治。方法:回顾性分析2018年1月至2019年12月在我院确诊DF的患者资料,采用流行病学方法分析数据,并回顾性分析临床表现、辅助检查、治疗及转归等。结果:(1)皖南地区2018年1月至2019年12月共报告输入性DF 10例,10例患者中位年龄为47.5岁,9例为男性;外出旅游及务工人员较多,感染者多来自东南亚地区。(2)10例患者均以发热为首发症状,4例伴颈部淋巴结肿大,皮疹、乏力各5例,咳嗽伴畏寒3例,颜面潮红2例,头痛、恶心、肌肉酸痛各1例;其中1例确诊并发急性胰腺炎。(3)10例患者中抗登革病毒IgM抗体检测阳性率达到100.0%,且7例患者表现白细胞减少,8例血小板计数减少,其中凝血酶原时间、活化部分凝血酶原时间延长各2例,亦出现血生化的改变。(4)病例发病至确诊间隔时间的中位数为5.5 d。经积极支持对症治疗,住院天数为4~10 d,10例患者均痊愈。结论:皖南地区输入性DF患者除了出现发热、皮疹等常见临床表现外,胰腺炎为DF的非典型表现。

Objective:To analyze the epidemiological and clinical characteristics of imported dengue fever(DF)in southern Anhui province and to improve the early clinical identification and diagnosis of imported DF.Methods:The data of 10 confirmed DF patients admitted in our hospital from Jan 2018 to Dec 2019 were retrospectively analyzed.Epidemiological methods were used to analyze the data.The clinical manifestations,auxiliary examination,treatment and curative effect were retrospectively analyzed.Results:(1)Among 10 patients,the median age was 47.5 years old,9 cases were male,and most of them were tourists and migrant workers,mainly from Southeast Asia.(2)Fever was the first symptom in 10 patients,4 with cervical lymphadenopathy,5 with rash,5 with asthenia,3 with cough and chills,2 with flushing,and 1 with headache,nausea or muscle soreness.One case was complicated with acute pancreatitis.(3)The positive rate of IgM antibody against dengue virus was 100.0%,and 7 patients showed leucopenia,8 thrombocytopenia,prothrombin time(PT)and activated partial prothrombin time(APTT)were prolonged in2 cases respectively,and with changes in blood biochemistry.(4)The median time between onset and diagnosis was 5.5 days.After positive support for symptomatic treatment,10 patients were all cured in 4 to 10 days.Conclusion:In the south of Anhui province,imported DF has the common clinical manifestations such as fever and rash,pancreatitis is the atypical manifestation.