87例登革热住院病例不同病程的临床特征分析  

Clinical features of different courses of 87 dengue fever inpatients

作　　者：徐文体[1,2] 陈燕清[3] 梁文佳[2] 尹炽标[3] 张复春[3] 杨芬[2] 罗会明[2] 

机构地区：[1]中国现场流行病学培训项目广东基地,广东广州510300 [2]广东省疾病预防控制中心 [3]广州市第八人民医院

出　　处：《华南预防医学》2007年第5期18-21,共4页South China Journal of Preventive Medicine

摘　　要：目的分析登革热病例不同病程的临床特征,为早期发现和诊断登革热病例提供依据。方法收集广州市某医院2006年3-9月期间住院的登革热病例临床症状、血常规、血液生化检查、血清抗体等资料,并进行描述性统计分析。结果共分析87例登革热病例,发病第1天所有病例出现发热,热程中位数为6 d;73.56%(64/87)病例出现头痛;27.59%(24/87)的病例出现骨痛;仅2.30%(2/87)的病例出疹。统计40例出疹病例,疹程中位数为6 d。发病的第5天,19.54%(17/87)有皮疹表现,谷草转氨酶(AST)及谷丙转氨酶(ALT)升高检出率分别为86.67%(13/15)、46.67%(7/15);白细胞及血小板减少检出率分别为80.00%(12/15)、73.33%(11/15)。IgM在发病第5天阳性检出率为53.33%(8/15)。IgG在发病第8天阳性检出率为54.55%(6/11)。结论登革热的早期临床体征同其他感染性疾病不容易鉴别,诊断存在一定的困难。建议在登革热流行期,应综合登革热临床特征和实验室结果,在发病5 d内,密切注意以发热、头痛、AST升高、WBC减少、血小板减少的病人。Objective To find clinical features of dengue fever inpatients in order to early detect and diagnose. Methods Information on clinical manifestations, blood routine and biochemical test, as well as serum antibody, were collected and analyzed by descriptive epidemiological methods among 87 dengue fever inpatients in a hospital. Results On the first day after onset, all cases had fever（ ≥38℃ ） and median febrile period was 6 days. 73.56% （64/87） cases had headache, 27.59% （24/87） joint pain, while only 2.30% （2/87） cases had rash with median rash period 6 days. On the fifth days after onset, 19.54% （17/87） cases had rash. 86. 67% （ 13/15 ） ,46. 67% （7/15） had increased AST and ALT level. 80.00% （ 12/15 ） ,73.33% （ 11/15 ） observed WBC and PLT reduction. IgM antibody was detected in 53.33% （8/15） cases on the fifth days after onset likewise IgG antibody in 54.55% （6/11） on the eighth days after onset. Conclusions Early clinical diagnosis of dengue fever was difficult due to overlapping manifestation with other communicable diseases, and close attention should be paid to cases with fever, headache, AST increase, WBC and PLT decrease in the first 5 days during epidemic.

关 键 词：登革热 临床特征 诊断 

分 类 号：R512.8[医药卫生—内科学]