422例发热伴血小板减少综合征临床特点分析  

Clinical characteristics in 422 patients with severe fever with thrombocytopenia syndrome

作　　者：徐哲[1] 崔宁 陈威巍[1] 秦恩强[1] 聂为民[1] 袁春 涂波[1] 许文[1] 赵敏[1] 

机构地区：[1]解放军第三○二医院感染性疾病诊疗与研究中心,北京100039 [2]解放军第一五四医院传染病科,信阳464000

出　　处：《传染病信息》2015年第1期28-32,共5页Infectious Disease Information

基　　金：解放军第三○二医院院内课题(YNKT2011004)

摘　　要：目的探讨发热伴血小板减少综合征的流行病学及临床特征。方法对河南省信阳市某医院2007年4月—2011年5月收治的422例发热伴血小板减少综合征病例资料进行回顾性分析。结果患者以成年农民为主,多在5—7月发病,21.80%患者有蜱叮咬史。症状主要表现为发热、乏力、肌肉酸痛、纳差、全身不适、腹泻、恶心、呕吐和头痛。体征主要表现为腹股沟淋巴结肿大伴触痛。实验室指标异常主要为WBC、PLT降低,ALT、AST、CK和LDH升高。68例死亡,病死率为16.11%。结论发热伴血小板减少综合征临床表现多样,伴有实验室检测指标明显异常。在诊疗过程中,宜采取有效的对症支持治疗。Objective To investigate the epidemiological and clinical features in patients with severe fever with thrombocytopenia syndrome（SFTS）. Methods A retrospective study was conducted in 422 SFTS patients with detailed medical records including epidemiology, clinical manifestations, laboratory findings, treatment procedures and prognosis, who were treated in a certain hospital in Xinyang City, Henan Province, from Apr. 2007 to May 2011. Results Adult farmers accounted for a large proportion, and the onset of the disease mainly occurred from May to July each year. A history of tick bites was found in 21.80% of the patients. The major clinical symptoms were fever, fatigue, muscle pain, loss of appetite, general malaise, diarrhea, nausea, vomiting and headache. The major clinical sign was enlargement and tenderness of superficial lymph node. Laboratory findings were characterized by decrease in WBC and PLT, and elevated levels of ALT, AST, CK and LDH. Sixty-eight patients died, with the fatality rate of 16. 11 %. Conclusions The clinical manifestations of the patients with SFTS may be diverse, usually accompanied by obvious abnormality of biochemical markers.Supportive treatment should be initiated in clinical practice.

关 键 词：血小板减少 发热 布尼亚病毒科感染 白蛉病毒属 病人 

分 类 号：R558.2[医药卫生—血液循环系统疾病] R512.99[医药卫生—内科学]