淮南地区流行性出血热46例临床与流行病学分析

The clinical and epidemiological analysis on 46 patients with epidemic hemorrhagic fever in Huainan areas

目的 了解近 10年淮南地区流行性出血热 ( EHF)的临床特征和流行病学特点。方法 对 46例EHF患者的临床及流行病学资料进行综合分析。结果 1有典型临床五期经过者仅为 39.13% ( 18/ 46 ) ,而重型和危重型患者分别占 2 3.91% ( 11/ 46 )和 19.5 7% ( 9/ 46 ) ;2 EHF病毒重叠乙型肝炎病毒 ( HBV)感染率高达43.48% ( 2 0 / 46 ) ,但单纯感染组与重叠感染组比较 ,两组的肝损害发生率差异有显著意义 ( P <0 .0 1) ,肾功能损害发生率差异无显著意义 ( P >0 .0 5 ) ;3流行性出血热患者肝、肾损害发生率分别为 2 3.91% ( 11/ 46 )和 86 .96 %( 40 / 46 ) ,84.78% ( 39/ 46 )的患者出现蛋白尿 ,76 .0 9% ( 35 / 46 )的患者出现血小板减少 ;心电图改变发生率为45 .6 5 % ( 2 1/ 46 ) ;4该病好发于春季 ( 1～ 3月 ) ,多见于男性青壮年农民 ;所检病例均有明确鼠类接触史。结论 淮南地区近年收治的 EHF病人逐年增多 ,其中 EHF重型和危重型病例较多 ,病死率较高 ,应引起重视。

Objective To study the clinical and epidemiological manifestation of epidemic hemorrhagic fever (EHF) in Huainan areas during recent ten years.Methods The compositive analysis of the clinical and epidemiological manifestation was made for the patients with epidemic hemorrhagic fever.Results The positive rates of topical patients, severe patients and imminent patients were 39.13%(18/46), 23.91%(11/46) and 19.57%(9/46) respectively. The eclipsing infection rate of EHF and HBV was 43.48%(20/46). There was high significant difference of hepatic injury and no significant difference of renal damage between in single infection and in eclipsing infection of epidemic hemorrhagic fever virus and HBV respectively (P< 0.01 ,P>0.05). The positive rates of the patients with hepatic injury, renal damage, proteinuria, thrombocytopenia and abnormal ECG were 23.91%(11/46), 86.96%(40/46), 86.96%(40/46), 84.78%(39/46) and 45.65%(21/46) and respectively. It was more common in spring season and adult peasants. All of the patients in our studies had obvious contact history of mouse.Conclusions More and more patients with EHF in Huainan areas were diagnosed and treated during recent years. The level of the severe patients and imminent patients with EHF and death rate were all higher.