18例成人重症水痘临床分析

Analysis of clinical characteristics in 18 adults with severe varicella

目的:分析成人重症水痘患者的临床特征,提高对该病的认识。方法:回顾性分析我院重症二科2018年1月至2024年3月收治的18例成人重症水痘患者的临床资料。结果:18例患者中男12例、女6例,平均年龄32.1岁(18~50岁),9例(50.0%)因器官移植、类风湿关节炎等基础疾病长期使用免疫抑制药物。异常实验室结果主要包括血小板计数降低12例(66.7%)、肝酶升高15例(83.3%)、心肌酶升高18例(100%)、N氨基末端脑钠肽升高15例(83.3%)、D-二聚体升高16例(88.9%)、降钙素原升高14例(77.8%)。6例(33.3%)因治疗效果不佳自动出院(3例)或死亡(3例)。15例(83.3%)合并肺部感染,其中11例合并Ⅰ型呼吸衰竭。结论:成人重症水痘患者以男性居多,死亡率较高。免疫抑制个体是成人重症水痘的高发人群。成人重症水痘合并肺部感染患者Ⅰ型呼吸衰竭发生率高。

Objective:To analyze the clinical characteristics of adult patients with severe varicella,and enhance the understanding of this disease.Methods:The clinical data of 18 patients with severe varicella admitted to our hospital from January 2018 to March 2024 were retrospectively analyzed.Results:Of the 18 patients,12 were males and 6 were females.The average age was 32.1 years(ranging from 18 to 50).Nine patients(50.0%)received long-term immunosuppressive drugs due to organ transplantation,rheumatoid arthritis,or other underlying diseases.Multiple laboratory abnormalities included decreased platelet count(12 cases,66.7%),elevated liver enzyme(15 cases,83.3%),elevated myocardial enzyme(18 cases,100%),elevated NT-pro BNP(15 cases,83.3%),elevated D-dimer(16 cases,88.9%),and elevated procalcitonin(14 cases,77.8%).Six patients(33.3%)discontinued treatment due to poor outcomes,of them,3 cases died.There were 15 patients infected with pneumonia,and 11 patients had typeⅠrespiratory failure.Conclusions:Severe varicella is more prevalent in adult males,and has a relatively high mortality rate.Immunocompromised adults are at higher risk for severe varicella infection.TypeⅠrespiratory failure is frequently observed in adults with severe varicella complicated with pulmonary infection.