2021年北京市门头沟区一例本地发热伴血小板减少综合征患者临床和流行病学特征分析  

Clinical and epidemiological characteristics of a case of severe fever with thrombocytopenia syndrome in Mentougou district,Beijing in 2021

作　　者：王志越[1] 宋丽君[1] 刘啸傲 窦相峰[2] 孙玉兰[2] Wang Zhiyue;Song Lijun;Liu Xiaoao;Dou Xiangfeng;Sun Yulan(Mentougou District Center for Disease Prevention,Beijing 102300,China;Beijing Center for Disease Control and Prevention,Beijing 100013,China)

机构地区：[1]北京市门头沟区疾病预防控制中心,北京102300 [2]北京市疾病预防控制中心,北京100013

出　　处：《疾病监测》2023年第10期1178-1181,共4页Disease Surveillance

摘　　要：目的描述北京市门头沟区发热伴血小板减少综合征(SFTS)患者感染来源、临床特征和流行病学特征,为制定SFTS防控措施提供科学依据。方法采用现场流调、查阅病历等方式获取患者临床、流行病学信息,采集血液标本进行核酸和抗体检测,进行媒介蜱和动物宿主调查。结果患者多年未出京,发病前活动范围为居住地周边。实时荧光定量聚合酶链式反应检测方法显示,患者血清SFTS病毒核酸阳性;血清抗体检测显示,IgM抗体阳性,病毒含量为1.9×10^(4)半数组织培养感染剂量(TCID50)/mL,临床症状以持续发热、进行性血小板减少、白细胞减少为主,服用抗病毒药利巴韦林后好转并逐渐痊愈,整个病程为20 d。媒介生物调查显示:在患者村落周围环境捕获到的媒介长角血蜱5只,SFTS病毒核酸阴性。病例家犬血液经检测显示SFTS病毒核酸和抗体均为阴性。结论该SFTS病例为北京市门头沟区首次报告,今后应加强病例监测,做好媒介生物监测和健康宣教。Objective To understand the sources of infection,clinical and epidemiological characteristics of a patient with severe fever with thrombocytopenia syndrome(SFTS)in Mentougou district,Beijing and provide scientific evidence for the development of SFTS prevention and control strategy.Methods An epidemiological investigation was conducted,and the patient's blood sample was collected.Real-time quantitative polymerase chain reaction and enzyme linked immunosorbent assay were used to detect SFTS virus(SFTSV)nucleic acid and antibodies.Additionally,investigations were carried out to identify the vector and host animal involved in the transmission of the virus.Results The investigation results showed that the patient had lived in local area without travel history outside Beijing in recent years.Real time fluorescence quantitative polymerase chain reaction test showed that the serum sample of the patient was SFTSV nucleic positive,and the serum antibody test showed positive result of IgM antibody,and the virus content was 1.9×10^(4)TCID50/mL.The patient exhibited clinical manifestations of fever,progressive thrombocytopenia and leukopenia.Following treatment with the antiviral drug Ribavirin,the patient gradually recovered with the entire illness lasting for a period of 20 days.The blood sample of domestic dog of the patient weas negative for both SFTSV nucleic acid and IgM antibody Five H.longicornis were captured in the surrounding area where the case lived,which were negative for SFTSV nucleic acid.Conclusion This case of SFTS was the first one reported in Mentougou.In the future,it is necessary to improve the surveillance for SFTS,vector surveillance and health education.

关 键 词：发热伴血小板减少综合征 临床特征 本地病例 

分 类 号：R211[医药卫生—中医学] R510