海南169例恙虫病病例特点分析  

Characteristics of 169 scrub typhus cases in Hainan province

作　　者：黄宪希[1] 高丽娟[2] 邓胜群 郭虹[1] 

机构地区：[1]海南医学院科学实验中心,海南海口571199 [2]海口市人民医院感染科,海南海口570208

出　　处：《中国热带医学》2015年第2期155-157,共3页China Tropical Medicine

基　　金：国家自然科学基金(No.81060140);海南医学院科研启动基金(No.2011011)

摘　　要：目的了解海南地区近年恙虫病的发病情况及临床特点,为减少恙虫病的临床误诊提供参考依据。方法收集海南省海口市三家三甲医院2011~2013年恙虫病病例,对所得资料进行统计分析。结果共收集恙虫病确诊病例169份,其中男性79例,女性90例,男女性别比例0.88;年龄最大的82岁,最小的仅122d,平均年龄（36.70±26.98）岁;10岁以下儿童组占35.50%（60/169）,显著高于其他年龄组（P〈0.01）。除了幼儿及学生外,患者的职业分布以农民为主,占38.46%（65/169）,其他由离退休人员、工人、居民及无业人员等组成,占24.26%（41/169）;全年均有病例,患者来自海南15个市县;均以发热为主要症状收治,其中140例有特征性焦痂或溃疡,占82.84%;发病前有野外接触史或虫媒叮咬史记录的38例,占总病例数的22.49%;外斐氏实验检测145例中阳性仅6例。结论 169例恙虫病以儿童、农民为主;海南岛分布广泛;全年发病,误诊率高;外斐氏反应实验室诊断此病敏感性及特异性低。Objective To investigate the clinical feature of 169 patients with tsutsgamushi disease from Hainan provinceso as to provide evidence for reducing misdiagnosis of the disease. Methods Data of scrub typhus cases hospitalized in threefirst- class hospitals at grade three during 2011- 2013 was collected and statistically analyzed. Results A total of 169 confirmed cases were investigated, including 79 male and 90 female patients, with a sex ratio of 0.88：1; Their ages ranged from122 d to 82 years old, with the mean value of（36.70±26.98） years; The proportion of children under 10 years old was 35.50%（60/169）, being significantly higher than that of other age groups.The scrub typhus mainly occurred among farmers（38.4%）besides children and students, and the rest were retirees, workers and the unemployed, accounting for 24.26% of all cases.Cases were observed all year round in 15 counties/cities of Hainan. All of them were admitted to hospital with the majorsymptom of fever. Statistics showed that 140 cases accounted for 82.84% had the specific sign of eschar or ulcer and 38 patients accounted for 22.49% had the history of field exposure or insects bite; Only 6 of the 145 cases were positive for Weil-Felix test. Conclusion The majority of the 169 scrub typhus cases were children and farmers, which widely distributedthroughout Hainan island; This disease occurred all year round with a high misdiagnosis rate; Both sensitivity and specificity ofWeil-Felix test were low for clinical diagnosis of the disease.

关 键 词：恙虫病 立克次体 误诊 海南 

分 类 号：R376[医药卫生—病原生物学]