海南地区120例类鼻疽病临床分型及特点  

Clinical types and characteristics of 120 cases of melioidosis in Hainan

作　　者：谢甜[1] 王旭明[2] 王敏[3] 黄奕江[1] XIE Tian;WANG Xuming;WANG Min;HUANG Yijiang(Department of Respiratory Medicine,Hainan General Hospital,Haikou 570311,China)

机构地区：[1]海南省人民医院呼吸内科,海口570311 [2]海南省人民医院检验科,海口570311 [3]海南省人民医院药学部,海口570311

出　　处：《中国感染与化疗杂志》2018年第4期360-364,共5页Chinese Journal of Infection and Chemotherapy

基　　金：海南省自然科学基金(817319)

摘　　要：目的总结海南地区类鼻疽病的流行病学特点及不同类型类鼻疽病的临床特点,提高对该病的认识。方法采用回顾性方法,分析海南省人民医院2010-2016年120例住院类鼻疽病患者的流行病学特点,并将患者分为急性型、亚急性型、慢性型,从发病年龄、病死率、复发率、合并基础疾病和治疗依从性等方面总结各型临床特点。结果 120例患者中男性占87.5%(105/120),农民占66.7%(80/120),合并糖尿病等基础疾病的患者占76.7%(92/120)。患者主要来自海南省沿海市县。急性型合并糖尿病等基础疾病率和病死率最高。慢性型以脏器脓肿为主要表现,该组发病年龄最低,但治疗依从性最差。亚急性型最为常见,以肺部、骨关节、泌尿系感染为主要表现。结论类鼻疽病是海南地区多发病,主要好发于沿海地区有糖尿病等基础疾病的男性农民。应提高对该病不同类型尤其是慢性型的认识,做到足量足疗程治疗,严格随访,降低病死率和复发率。Objective To summarize the epidemiological features and clinical manifestations of different types of melioidosis in Hainan,and so improve clinical awareness of melioidosis.Methods A total of 120 inpatients with melioidosis treated in Hainan General Hospital during the period from 2010 to 2016 were reviewed retrosepctively.These cases were classified into acute,subacute,and chronic types.The corresponding clinical characteristics were summarized in terms of age of onset,mortality,relapse rate,comorbidity,and treatment compliance.Results Most(87.5%)of the patients were men.Diabetes mellitus was the leading underlying disease(76.7%,92/120).About two-thirds(66.7%)of the patients were farmers.These melioidosis cases were mostly the residents in the coastal region in Hainan.Acute melioidosis was associated with the highest mortality and risk factor of diabetes mellitus.The patients with chronic melioidosis showed the lowest age of onset and the worst treatment compliance.Subacute melioidosis was the most common type in these cases,which was characteristic of infection in lungs,bone and joint,as well as urinary tract.Conclusions Melioidosis is a common disease in Hainan,especially in the male farmers living in coastal region,who have underlying diabetes mellitus.Awareness should be improved to recognzie the cinical types of melioidosis and the corresponding manifestations.Melioidosis should be treated with full dose and duration of antimicrobial agents and close follow-up so as to reduce mortality and relapse rate.

关 键 词：类鼻疽病 类鼻疽伯克霍尔德菌 临床表现 

分 类 号：R754.3[医药卫生—皮肤病学与性病学]