重庆两江新区201例成人登革热临床特点分析

Clinical features of 201 patients with dengue fever in Chongqing Liangjiang New Area

目的:提高临床医师对登革热的认识水平。方法:回顾性分析2019年8月至10月两江新区第一人民医院确诊收治的201例登革热患者临床资料。计数资料采用卡方检验,计量资料采用t检验。结果:201例登革热患者中,男性97例(48.26%),女性104例(51.74%),>60岁患者(老年组)40例(19.90%)。主要临床表现为发热(99.00%)、乏力(85.07%)、肌肉酸痛(85.57%)。实验室检查显示,多数患者有中性粒细胞减少(90.53%)、血小板减少(70.00%)、肝功能损害(30.00%)。老年组血小板下降发生率较青中年组高(66.67%vs. 85.25%,P=0.04)。此外,老年组肝功能损害发生率较高(50.00%vs. 25.64%,P=0.01),且肝功能损害更重。病原学检查显示,本地感染患者均为基因1型,2例输入性病例分别为基因2型和基因3型。治疗主要以对症支持治疗,多数为轻症,预后好。结论:本次登革热流行主要为基因1型,以发热、乏力、肌肉酸痛为典型临床表现,多伴有中性粒细胞及血小板下降、肝功能损害,老年患者更为明显,需引起高度重视。

Objective:To improve clinician’s understanding of dengue fever. Methods:The clinical data of 201 dengue fever patients admitted to the First People’s Hospital of Liangjiang New Area from August to October,2019 were retrospectively analyzed. Chi-square test was used for discontinuous variables,and t test was used for continuous variables. Results:Among 201 dengue fever patients,97(48.26%) were male,and 104(51.74%) were female. The number of them over 60 years old was 40(19.90%). The common manifestations included fever(99.00%),fatigue(85.07%),and myalgia soreness(85.57%). Laboratory examination showed that most patients had neutropenia(90.53%),thrombocytopenia(70.00%),and liver function damage(30.00%). The incidence of thrombocytopenia was higher in elderly patients than that in young and middle-aged patients(66.67% vs. 85.25%,P=0.04). In addition,the incidence of liver damage in the elderly patients was higher(50.00% vs. 25.64%,P=0.01),with more serious damage. Etiological examination showed that all patients’ dengue virus RNA(DENA-RNA) were positive,the locally infected patients were genotype 1,and two imported patients were genotype 2 and genotype 3. All patients were treated by symptomatic support to prevent complications,most patients with mild symptoms and with good prognosis. Conclusion:In 2019,the epidemic of dengue fever in our district is mainly genotype 1,with fever,fatigue,myalgia soreness as typical clinical features,accompanied by neutropenia,thrombocytopenia and liver function damage,especially in elderly patients,which should be paid great attention to.