黑热病166例病例流行病学与临床分析  

Epidemiological and Clinical Analysis of 166 Kala-azar Cases

作　　者：张丽萍[1] 张富南[1] 

机构地区：[1]四川省疾病预防控制中心,四川成都610041

出　　处：《寄生虫病与感染性疾病》2010年第4期181-186,共6页Parasitoses and Infectious Diseases

摘　　要：目的通过对黑热病病例的分析,探讨黑热病的流行病学与临床特点,为临床减少误诊提供依据。方法对就诊患者采用rk39试纸条检测,阳性者收集流行病学、发病情况、临床表现以及其在医院的病原学、辅助检查和病历记录等资料,免费给予锑剂药物治疗;对资料进行整理、统计和回顾性分析。结果病例均有传播季节在流行区居住史;全年各月均有发病,非流行区病例以到九寨沟县、黑水县和甘肃、新疆流行区感染后发病的居多。发病男性高于女性。流行区16岁以下发病较多,占35.09%;非流行区以16岁及以上发病居多,占97.85%。病程最短者为7d,最长者达2年;主要临床表现为长期不规则发热占100.00%,进行性肝脾肿大占98.00%;以白细胞为主的全血细胞减少及血浆球蛋白增高分别占83.33%和93.18%。rk39试纸条检查与骨髓穿刺的阳性符合率为100.00%,rk39试纸条的检出率明显高于骨髓穿刺(P<0.01)。结论加强流行区居民和流动人口防病宣传,从流行病学入手控制黑热病;黑热病的早期诊断关键是了解流行病学资料,认识该病的临床特点,掌握骨髓或rk39试纸条检查方法,防止漏诊误诊。Objective To analyze epidemiological and clinical characteristics of kala-azar and provide evidence to reduce the misdiagnosis of the disease. Methods The rk39 dipstick was used, as for those with positive results, the data of epidemiology, incidence, clinical manifestation, etiology, accessory examination and medical records were collected for retrospective analysis, and free antimonials treatment was given. Resuits All the cases had the history of living in epidemic areas in transmission seasons. The disease occurred all the year round. Most patients in non-epidemic areas had been to Jiuzhaigou county, Heishui county, Gansu province, Xinjiang Province. There were more male cases than female cases. The patients under 16 years old accounted for 35.09% in epidemic areas, the patients aged ≥ 16 years for 97.85% in non-epidemic areas. The shortest course of the disease was 7 days, while the longest was 2 years. The main clinical symptoms included long-term irregular fever（ 100. 00% ）. progressive liver（98.00% ） and spleen swelling（ 83.33% ）,whole blood cell reducing（ mainly on white blood cells） and globulin increasing （ 93.18% ）. The positive coincidence rate of rk39 dipstick and bone marrow biopsy was 100. 00%. The detection rate of rk39 dipstick was obviously higher than bone marrow biopsy （ P 〈 0. 01 ）.Conclusion It is necessary to strengthen health education about kala-azar prevention and control among the people in epidemic area. The early diagnosis of kala-azar depends on the awareness of epidemiologieal history of the patients and the detections by rk39 dipstick and bone marrow biopsy.

关 键 词：黑热病 病例 流行病学 临床 分析 

分 类 号：R531.6[医药卫生—内科学]