河南省新安县1例新发内脏利什曼病临床及流行病学调查分析  

Clinical and epidemiological investigation of a new case of visceral leishmaniasis in Xin'an county,Henan province

作　　者：刘英[1] 郭正印[1] 孙磊[1] 张东东 Liu Ying;Guo Zhengyin;Sun Lei;Zhang Dongdong(Luoyang Prefectural Center for Disease Control and Prevention,Luoyang 471000,Henan,China;The First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,Henan,China)

机构地区：[1]洛阳市疾病预防控制中心,河南洛阳471000 [2]河南科技大学第一附属医院,河南洛阳471000

出　　处：《疾病监测》2023年第9期1134-1137,共4页Disease Surveillance

摘　　要：目的了解新发黑热病的传染源,传途径,易感人群,临床表现和实验室诊断方法,药物治疗及预防措施,为医务人员提供黑热病的防治经验。方法采用回顾性调查法,根据市县两级疾病预防控制中心流行病学调查,市县两级医院临床病历统计分析整理。结果患者以不规则发热为主、全血细胞减少、白球比倒置为主要临床表现,骨髓和脾脏穿刺检出利什曼原虫,rK39免疫层析试纸条抗体阳性,PCR扩增和测序显示为婴儿利什曼原虫。流行病学调查发现有传播黑热病的媒介中华白蛉。本村犬监测黑热病抗体虽为阴性,但邻村犬只黑热病血清学阳性率为10%。葡萄糖酸锑钠治疗黑热病人后痊愈,疗程短效果好。结论疫区要定期监测白蛉和犬只感染情况,及时提供科学防治数据。医务人员应提高对黑热病的再认识,减少漏诊和误诊。Objective To understand the source of infection,transmission route,susceptible population,clinical manifestations and laboratory diagnostic methods,drug treatment and preventive measures of new leishmaniasis,To provide medical personnel with experience in the control of kala-azar.Methods The retrospective investigation method was used to analyze and collate clinical records of city and county hospitals according to epidemiological investigation of city and county centers for Disease Control and Prevention.Results The main clinical manifestations of the patients were irregular fever,pancytopenia,and inverted white bulb ratio.Bone marrow and spleen punctures showed leishmania,rK39 immunochromatographic strip was positive for antibody,PCR amplification and sequencing revealed Leishmania infantile.Epidemiological investigation revealed the presence of Phlebotomus sinensis,the vector of leishmaniasis transmission.Although the detection of kala-azar antibody in local village dogs was negative,the serological positive rate of kala-azar in neighboring village dogs was 10%.The treatment of leishmaniasis with antimony sodium gluconate was short and effective.Conclusion Epidemic areas should regularly monitor the infection of phlebotomus and dogs,and provide scientific control data in a timely manner.Medical staff should raise awareness of kala-azar and reduce missed diagnosis and misdiagnosis.

关 键 词：内脏利什曼病 婴儿利什曼原虫 临床表现 实验室检测 中华白蛉 

分 类 号：R211[医药卫生—中医学] R378.3