墨脱县47例恙虫病诊治情况分析  

Analysis of 47 cases of Tsutsugamushi disease in Motuo County

作　　者：宋莲花 次仁玉珍 拉珍 王文会[2] SONG Lian-hua;CI Ren-yuzhen;LA Zhen;WANG Wen-hui(Department of Internal Medicine,Motuo County People’s Hospital,Nyingchi 860700,China;Department of Cardiovascular Medicine,Foshan Hospital of Traditional Chinese Medicine,Foshan 528000,China)

机构地区：[1]墨脱县人民医院内科,西藏林芝860700 [2]佛山市中医院心血管内科,广东佛山528000

出　　处：《佛山科学技术学院学报（自然科学版）》2022年第3期77-80,共4页Journal of Foshan University(Natural Science Edition)

摘　　要：目的通过对47例恙虫病诊治情况分析,规范和提高本地恙虫病诊治水平,减少误诊误治及危重症发生率。方法收集墨脱县人民医院2017年1月-2020年1月期间,住院诊治出院诊断为恙虫病的患者47例病例资料,进行回顾性分析。结果墨脱县5-11月期间可见恙虫病流行,6-9月为高发季节;恙虫病患者特异性焦痂,常见于腋下、臀沟等潮湿、隐蔽、体味明显处;延误诊治情况突出,并发症发生率高;血小板值、嗜酸粒细胞百分比下降明显;降钙素原>0.5 ug/L组,乳酸脱氢酶值较降钙素原<0.5 ug/L组明显升高,P<0.01,有显著统计学意义;多西环素及阿奇霉素对该病治疗效佳,治愈率95.74%。结论墨脱县为恙虫病重要自然疫源地,恙虫病患者可发现特异性焦痂及血小板值、嗜酸粒细胞百分比明显下降,多西环素及阿奇霉素治疗该病有效。血降钙素原、乳酸脱氢酶值高低可作为恙虫病预后的重要参数。Objective To standardize and improve the diagnosis and treatment of Tsutsugamushi disease in order to reduce the rate of misdiagnosis and mistreatment and critical cases.Methods From January 2017 to January 2020,47 patients diagnosed as Tsutsugamushi disease in Motuo County People’s Hospital were collected and analyzed retrospectively.Results Tsutsugamushi disease was prevalent from May to November in Motuo County,with a high incidence from June to September.The patients with Tsutsugamushi disease had specific Eschar,which was often found in the moist,hidden and smelly places such as armpit and buttock cleavage.The delay in diagnosis and treatment was prominent,and the incidence of complications was high.The platelet value and the percentage of eosinophils were significantly decreased in the Procalcitonin>0.5 ug/L Group and the Lactate dehydrogenase value was significantly higher than that in the Procalcitonin>0.5 ug/L Group,P<0.01.Doxycycline and Azithromycin were effective in treating the disease with a cure rate of 95.74%.Conclusion Motuo County is an important natural foci of tsutsugamushi disease,and patients with Tsutsugamushi disease can find marked decrease in specific Eschar,platelet count and percentage of eosinophils.Doxycycline and Azithromycin are effective in the treatment of Tsugamushi disease.The level of Procalcitonin and Lactate dehydrogenase can be used as important prognostic parameters of Tsutsugamushi disease.

关 键 词：恙虫病 降钙素原 乳酸脱氢酶 多西环素 墨脱县 

分 类 号：R513.2[医药卫生—内科学]