成都市35例猴痘患者临床特征分析  

Analysis of clinical characteristics of 35 patients with human monkeypox in Chengdu City

作　　者：赵本南 刘大凤 包蕾 郭利华 姜晓曼[2] 毛毅 ZHAO Bennan;LIU Dafeng;BAO Lei;GUO Lihua;JIANG Xiaoman;MAO Yi∗(Public Health Clinical Center of Chengdu,Chengdu,Sichuan 610061,China;Chengdu Center for Disease Control and Prevention,Chengdu,Sichuan 610000,China)

机构地区：[1]成都市公共卫生临床医疗中心,四川成都610061 [2]成都市疾病预防控制中心,四川成都610000

出　　处：《中国热带医学》2023年第11期1169-1172,共4页China Tropical Medicine

基　　金：重庆市科学技术局重大传染病全程智慧管理平台研发及应用项目(No.cstc2020jscx-cylhX0001);成都市高水平临床重点专科建设项目-传染病学专项。

摘　　要：目的 分析成都市35例猴痘患者的临床特征,为猴痘疫情防控提供理论依据。方法 将2023年7月1日-7月23日经成都市疾病预防控制中心判定为猴痘病毒感染的35例患者为研究对象,收集其一般临床资料、血实验室检查、淋巴结超声及胸CT结果,分析成都市猴痘患者的临床特征。结果 35例猴痘患者均为男性,青壮年,无重症及死亡病例,32例(占91.4%)为男男性行为(MSM)者,30例在发病前21 d有男男同性性行为,其中13例采取保护性措施。26例(占74.3%)患者有发热症状,其中19例在皮疹生长1~6 d出现发热。皮疹首发部位在外生殖器例数最多。彩超提示所有患者均有腹股沟淋巴结肿大。26例(占74.3%)患者C反应蛋白升高,19例CD3^(+)CD4^(+)T/CD3^(+)CD8^(+)T<1.0,15例(占42.8%)患者合并HIV感染,分别有28.5%(10/35)的患者并发皮肤感染及肛门直肠炎。从皮疹生长至所有皮疹痂壳脱落的平均时间为14.8 d。结论 性活跃期的MSM人群为猴痘病毒主要感染对象。成都市猴痘患者中,皮疹始于生殖器区域及皮疹出现在全身症状之前常见,多伴有浅表淋巴结肿大且尤以腹股沟淋巴结肿大的发生率更高,并发症以皮肤感染及肛门直肠炎为主。猴痘患者的细胞免疫功能异常主要体现在CD3^(+)CD4^(+)T/CD3^(+)CD8^(+)T比值倒置。目前尚无证据显示男男行为中采取保护性措施可降低猴痘感染风险。Objective To summarize the clinical characteristics of 35 patients with human monkeypox in Chengdu City,in order to provide theoretical basis for prevention and control of monkeypox epidemic in China.Methods A total of 35 patients diagnosed with monkeypox infection by Chengdu CDC from July 1 to July 23,2023 were included in our study.The results of general clinical data,blood laboratory tests,lymph node ultrasound and chest CT results were collected in order to analyze the clinical features of human monkeypox patients in Chengdu City.Results All 35 monkeypox patients were young adult males,and there were no serious or fatal cases.Among them,32 cases(91.4%)were men who have sex with men(MSM),and 30 cases had engaged in male-to-male sexual behavior within 21 days prior to the onset of the disease,of which 13 cases had taken protective measures.Fever symptoms were observed in 26 cases(74.3%)of the patients,with 19 cases experiencing fever within 1-6 days after the appearance of rash.The initial rash commonly occurred in the male external genitalia.Color ultrasound examinations indicated that all patients had swollen inguinal lymph nodes.C-reactive protein was elevated in 26 cases(74.3%)of patients,and 19 cases showed CD3+CD4+T/CD3+CD8+T<1.0.15 cases(42.8%)of the patients were infected with both monkeypox virus and HIV,28.5%(10/35)of patients had concomitant skin infections and anorectal proctitis,respectively.The mean time from rash onset to the shedding of rash scabs was 14.8 days.Conclusions The MSM population in sexually active age group is the main infection object of human monkeypox virus.In monkeypox patients in Chengdu City,the rash starting at genital areas and rash occurring before systemic symptoms were common.Swollen inguinal lymph nodes are especially common in monkeypox patients.Skin infection and anorectal proctitis are the most common complications in monkeypox patients in Chengdu City.The abnormal cellular immune function in monkeypox patients is mainly reflected in the inverted ratio of CD3+CD4+T/CD

关 键 词：猴痘 猴痘病毒 临床特征 淋巴结肿大 男男性行为 

分 类 号：R373.31[医药卫生—病原生物学]