厦门市恙虫病例流行病学资料与临床表现  

Epidemiologial and clinical manifestations of tsutsugamushi cases in Xiamen City

作　　者：王雪莲[1] 郭志南[2] 李峰[1] 傅建国[1] 陈潇潇[1] 牛建军[1] 

机构地区：[1]厦门大学附属中山医院,福建361004 [2]厦门市疾病预防控制中心,福建361021

出　　处：《海峡预防医学杂志》2014年第4期6-8,共3页Strait Journal of Preventive Medicine

基　　金：福建省自然科学基金项目(No.2013D008);厦门市科技计划项目(No.3502Z20144062);厦门市卫生局医学科研项目(No.WSK2010-01)

摘　　要：目的分析厦门市近年恙虫病患者流行病学资料和临床表现,提高确诊率。方法回顾性分析46例恙虫病住院患者的病历资料。结果患者多为成年人（91.3%）,多有野外活动史（84.8%）,发病季节2~11月。35例（76.1%）出现多脏器损伤,少数合并脑膜炎、胰腺炎及格-巴二氏综合征（GBS）等并发症;合并肾综合征出血热（HFRS）1例。OXk≥1∶160仅12例（27.9%）。入院当天确诊25例（54.3%）。结论恙虫病多发生于有野外活动史者;临床表现复杂,易误诊。详细询问流行病史、全面查体、完善检验是减少误诊关键。Objective To analyze the epidemiological and clinical features of tsutsugamushi cases for increasing the rate of correct diagnosis. Methods Clinical data of 46 hospitalized tsutsugamushi cases were analyzed retrospectively. Results Most cases were adult（91.3%）and shown the history of outdoor activities（84.8%）. All cases occurred from Feb. to Nov. 35 cases （76.1 %） presented multiple organ damages. Seldom cases presented meningitis, pancreatitis and Guil- lain-Barr Syndrome （GBS）. One case was diagnosed hemorrhagic fever with renal syndrome （HFRS）. 12 cases （27.9 % ） performed OXk ≥1 ： 160 only.25 cases 54.3% were diagnosed tsutsugamushi disease on the day of admission. Conclusion Most tsutsugamushi cases show history of outdoor activities. Clinical manifestations of tsutsugamushi ca- ses are complex and likely to be misdiagnosed. Taking disease history, physical examination and laboratory tests care- fully are the key measures to reduce the disease misdiagnosis.

关 键 词：恙虫病 临床症状 误诊 流行病学 

分 类 号：R513.2[医药卫生—内科学]