山东省输入性疟疾流行病学及临床特点分析  

Analysis on epidemiology and clinical characteristics of imported malaria in Shandong Province

作　　者：王忠磊[1] 付婷霞[1] 胡颖欣[1] 魏艳彬[1] 史世俊[1] 马巧荣[1] 毛德华[1] 

机构地区：[1]山东省寄生虫病防治研究所,山东济宁272033

出　　处：《公共卫生与预防医学》2016年第1期16-19,共4页Journal of Public Health and Preventive Medicine

基　　金：中国全球基金疟疾项目实施性研究专项(201201055)

摘　　要：目的探讨输入性疟疾流行病学及临床特点,为预防、诊断及治疗提供科学依据。方法对2014年1—12月输入性疟疾患者的流行病学资料、临床表现、实验室检查、诊断及治疗情况进行系统性分析。结果共收集49例输入性疟疾,患者为赴非洲及东南亚等12个国家务工回归人员,病例全年散发,恶性疟占93.88%,无明显季节性,人群以青壮年民工为主。患者临床主要表现为发热、头痛、畏寒、乏力、肌肉酸痛、腹泻、肝脾肿大等多种症状;实验室检查主要表现为贫血、血小板减少、白细胞增高、转氨酶增高、蛋白尿及肾功能异常。首诊有22.45%的病例被误诊为呼吸系统及消化系统疾病等。结论输入性疟疾以恶性疟为主,患者是赴非洲等地务工回归人员,全年均有发病;患者临床表现复杂多样、并发症多;早期诊断和抗疟治疗及对症处理是救治重症疟疾的关键。对出国务工人员开展疟防知识宣传,提高自我保护意识,减少务工期对疟疾的感染,加强对务工回归人员的疟疾监测,早期发现和治疗,减少重症疟疾和死亡病例的发生。Objective To investigate the epidemiological and clinical characteristics of imported malaria,and provide basis for prevention,diagnosis and treatment. Methods Epidemiological data,clinical manifestations,laboratory examination,diagnosis and treatment of 49 imported malaria cases were systematically analyzed. Results 49 sporadic cases of imported malaria were distributed with no obvious seasonality in the whole year. The young and middle-aged migrant workers were the main population. All the patients had the history of living in the epidemic area and the history of mosquito bites. The main clinical manifestations were fever,headache,chills,fatigue,muscle pain,diarrhea,liver and spleen enlargement and so on. Laboratory examination indicated anemia,platelet reducing,increase of white blood cells and transaminases,protein-uria and renal dysfunction. 22. 45% of the first diagnosed cases who were misdiagnosed as respiratory system and digestive system diseases. Conclusion There were no obvious seasonal characteristics among the imported malaria cases, mainly malignant ones. The clinical manifestations were complex and diverse with many complications. The early diagnosis and rational drug-use were the key for the treatment of severe imported malaria. Health education of malaria and enhancement of self-protection awareness were significant for reducing malaria infection. Strict surveillance of malaria among the migrant workers,early detection and treatment may reduce the occurrence of severe malaria and death cases.

关 键 词：输入性疟疾 流行病学 临床特点 蒿甲醚 青蒿琥酯 

分 类 号：R531.3[医药卫生—内科学]