754例成人登革热住院患者临床特征分析  

Epidemiological and clinical characteristics of 754 hospitalized adults with dengue fever

作　　者：程宛乔 许琪华 胡卫维 林路平[2] 单西云[3] 谭行华 CHENG Wanqiao;XU Qihua;HU Weiwei;LIN Luping;SHAN Xiyun;TAN Xinghua(Artemisia Annua Research Center,Guangzhou University of Chinese Medicine,Guangzhou,Guangdong 510060,China;Guangzhou Eighth People's Hospital,Guangzhou Medical University,Guangzhou,Guangdong 510405,China;The People's Hospital of Xishuangbanna Dai Nationality Autonomous Prefecture,Xishuangbanna,Yunnan 666100,China)

机构地区：[1]广州中医药大学青蒿研究中心,广东广州510060 [2]广州医科大学附属市八医院,广东广州510405 [3]云南省西双版纳傣族自治州人民医院,云南西双版纳666100

出　　处：《热带医学杂志》2024年第4期560-563,共4页Journal of Tropical Medicine

基　　金：国家科技重大专项(2018ZX10101001-005-002);国家自然科学基金(81730110)。

摘　　要：目的分析广州市及西双版纳地区754例成人登革热住院患者临床特征,为登革热的临床诊治及人群防治提供参考依据。方法回顾性分析2018年1月-2019年12月广州市第八人民医院、西双版纳傣族自治州人民医院、西双版纳精神卫生防治中心、勐海县打洛镇中心卫生院收治的754例成人登革热住院病例的一般资料、实验室检查、临床表现,对登革热的临床特点和发病特征进行描述性分析。结果754例患者中,219例合并基础疾病。发病年龄高峰为18~59岁,占比77.59%(585/754);发病时间高峰为8-11月,本土病例688例(91.25%),境外输入性病例66例(8.75%)。常见的临床表现为发热(94.16%,710/754)、骨/关节/肌肉酸痛(60.21%,454/754)、头痛(50.80%,382/754),消化道症状和呼吸道症状也较常出现。329例病毒分型,Ⅰ型占68.69%(226/329),Ⅱ型占28.27%(93/329),Ⅲ型占3.98%(9/329),Ⅳ型占0.30%(1/329)。实验室检查主要表现为白细胞计数减少(63.12%,476/754),红细胞比容升高(30.2%,145/480),血小板计数减少(72.28%,545/754),乳酸脱氢酶升高(67.64%,510/754),丙氨酸氨基转移酶(49.20%,371/754)、天门冬氨酸氨基转移酶(74.14%,559/754)升高。经对症支持治疗同时积极防治并发症,678例(89.92%)好转或痊愈,转重症76例(10.08%)。结论2018-2019年广州市和西双版纳地区登革热住院患者临床表现符合登革热发生、发展的一般规律,以登革病毒Ⅰ型感染为主,经对症支持治疗和积极防治并发症后,大部分患者预后良好。Objective To analyze the clinical characteristics of 754 adult dengue inpatients in Guangzhou and Xishuangbanna,and provide reference for clinical diagnosis,treatment and population prevention and treatment of dengue fever.Methods The general data,laboratory examination and clinical manifestations of 754 adult dengue inpatients admitted to the Guangzhou Eighth People's Hospital,the Xishuangbanna Dai Autonomous Prefecture People's Hospital,the Xishuangbanna Mental Health Prevention and Control Center and the Menghai County Daluo Town Central Health Center from January 2018 to December 2019 were retrospectively analyzed.The clinical and pathogenic characteristics of dengue fever were analyzed descriptively.Results Among 754 patients,219 cases were complicated with underlying diseases.The peak age of onset was 18-59 years old,accounting for 77.59%(585/754).The peak time of onset was from August to November,with 688(91.25%)local cases and 66(8.75%)imported cases.The common clinical manifestations were fever(94.16%,710/754),bone/joint/muscle soreness(60.21%,454/754),headache(50.80%,382/754),digestive tract symptoms and respiratory tract symptoms were also more common.The 329 cases were classified as typeⅠ(68.69%,226/329),typeⅡ(28.27%,93/329),typeⅢ(3.98%,9/329),and typeⅣ(0.30%,1/329).The main findings of laboratory examination were decreased white blood cell count(63.12%,476/754),increased RBC(30.2%,145/480),decreased platelet count(72.28%,545/754),and increased lactate dehydrogenase(67.64%,510/754),alanine aminotransferase(49.20%,371/754)and aspartate aminotransferase(74.14%,559/754).678 cases(89.92%)were improved or recovered,and 76 cases(10.08%)were transferred to severe condition.Conclusion The clinical manifestations of dengue fever inpatients in Guangzhou and Xishuangbanna in 2018-2019 were in line with the general pattern of dengue fever occurrence and development,with dengue virus type I infection predominating,and most patients had a good prognosis after symptomatic supportive treatment and active prev

关 键 词：登革热 临床特征 流行病学 广州 西双版纳 

分 类 号：R512.8[医药卫生—内科学]