2015—2021年三明市恙虫病流行病学和临床特征分析  

Analysis on the epidemiological and clinical characteristics of scrub typhus in Sanming city from 2015 to 2021

作　　者：叶敏贞[1] 张南文[2] YE Min-zhen;ZHANG Nan-wen(Sanming Municipal Hospital of Integrated Traditional Chinese and Western Medicine,Sanming,Fujian 365001,China;不详)

机构地区：[1]三明市中西医结合医院,福建365001 [2]福建医科大学药学院

出　　处：《应用预防医学》2022年第5期438-441,445,共5页Applied Preventive Medicine

摘　　要：目的分析2015—2021年三明市恙虫病病例的临床症状和流行病学特征,为制定恙虫病防治策略和措施提供参考依据。方法对2015年5月—2021年5月三明市中西医结合医院收治的恙虫病病例临床资料及流行病学信息进行回顾性调查,同时采用描述性流行病学方法进行分析。结果共收治恙虫病病例137例,发病主要集中在中青年组,30~50岁年龄组占比最高(64.97%)。时间分布方面,全年均有发病,主要集中在夏秋季,发病峰值在每年的7月。职业分布方面,农民占比最高(80.83%)。主要临床表现为头痛(89.05%,122/137)、焦痂(80.29%,110/137)、寒颤(78.83%,108/137)、皮疹(74.45%,102/137)和肌痛(67.88%,93/137);出现焦痂症状的部位以腰部、腹股沟区以及腋窝为主。病例中91.97%有C反应蛋白水平升高,45.26%有红细胞沉降率升高,59.85%有ALT和AST水平升高。病例IgM抗体阳性占39.42%(54/137),IgG抗体阳性占10.95%(15/137)。结论恙虫病临床表现复杂、缺乏特异性,易出现误诊和漏诊,应加强病原检测和医务人员培训,以降低恙虫病感染风险。Objective To analyze the clinical symptoms and epidemiological characteristics of scrub typhus cases in Sanming city from 2015 to 2021,and provide reference for the formulation of scrub typhus prevention strategies and measures.Methods The clinical data and epidemiological information of scrub typhus cases admitted to Sanming Hospital of Integrated Traditional Chinese and Western Medicine during the period between May 2015 and May 2021 were retrospectively investigated and analyzed by descriptive epidemiological methods.Results A total of 137 scrub typhus cases were treated,mainly found in the young and middle-age groups,with the highest proportion in the age group of 30-50 years old(64.97%).In terms of time distribution,the disease occurred throughout the year,mainly in summer and autumn,with the peak incidence in July each year.Among all occupation groups,farmers accounted for the highest proportion(80.83%).The main clinical manifestations were headache(89.05%,122/137),eschar(80.29%,110/137),chills(78.83%,108/137),rash(74.45%,102/137),and myalgia(67.88%,93/137).The areas where eschar symptoms appeared were mainly the waist,groin,and armpit.Elevated C-reactive protein level was detected in91.97%of patients,increased erythrocyte sedimentation rate was detected in 45.26%of patients,and elevated ALT and AST levels were measured in 59.85%of patients.There were 39.42%(54/137)of patients tested positive for IgM antibody,and 10.95%(15/137)of patients tested positive for IgG antibody.Conclusion The clinical manifestations of scrub typhus are complex and lack specificity,which missed diagnosis and misdiagnosis are easy to occur.The training on pathogenic detection should be strengthened among healthcare professionals to reduce the risk of scrub typhus infections.

关 键 词：恙虫病 流行病学特征 临床特征 传播风险 防治措施 

分 类 号：R513.2[医药卫生—内科学]