40例疑似发热伴血小板减少综合症流行病学和临床分析

来源 :现代预防医学 | 被引量 : 0次 | 上传用户:yuanjinxing1987
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目的探讨发热伴血小板减少综合征(Severe Fever with Thromobocytopenia Syndrome,SFTS)流行病学及临床特征,为预防和控制新型布尼亚病毒(Severe Fever with Thromobocytopenia Syndrome Bunyavirus,SFTSV)感染提供依据。方法采用回顾性调查、现场流行病学调查方法进行问卷调查,采用实时定量反转录聚合酶链反应方法检测患者血清SFTSV RNA。结果 2012年某院共报告40例疑似病例,经实验室确诊21例,阳性率52.50%。确诊病例中男10例,女11例;病例多分布于丘陵地区农村,16例(76.19%)为农民,以从事与农业生产相关作业的中老年为主;病例主要集中在6-8月份;多数病例发病前无明确的蜱虫叮咬史。主要临床症状多为发热、头晕、头痛、乏力、四肢酸痛、恶心、呕吐、腹痛、腹泻、肢体抖动、意识不清、烦躁等;实验室检查主要是WBC、PLT降低,ALT、AST、CK、LDH升高。结论 SFTS病例多发生在夏季,呈散在发生;中老年为主;职业以农民为主;临床表现以发热伴白细胞、血小板减少和多脏器功能损害为主。 Objective To investigate the epidemiological and clinical features of Severe Fever with Thromobocytopenia Syndrome (SFTSV) and provide basis for prevention and control of Severe Fever with Thromobocytopenia Syndrome Bunyavirus (SFTSV) infection. Methods A retrospective survey and on-site epidemiological survey were conducted to investigate the serum SFTSV RNA level by real-time quantitative reverse transcription-polymerase chain reaction (RT-PCR). Results A total of 40 suspected cases were reported in a hospital in 2012, and 21 were confirmed by laboratory tests. The positive rate was 52.50%. Among the confirmed cases, 10 were males and 11 were females; the cases were mostly distributed in rural areas in hilly areas and 16 (76.19%) were peasants, mainly engaged in middle-aged and elderly-related jobs related to agricultural production; the cases mainly concentrated in June-August; Most cases before the onset of a clear history of tick bites. The main clinical symptoms are fever, dizziness, headache, fatigue, limb pain, nausea, vomiting, abdominal pain, diarrhea, limb jitter, confusion, irritability, etc .; laboratory tests are mainly WBC, PLT decreased, ALT, AST, CK, LDH increased. Conclusions The cases of SFTS mostly occurred in the summer, with scattered occurrence; middle-aged and old-aged; occupation was dominated by peasants; clinical manifestations were fever with leukopenia, thrombocytopenia and multiple organ dysfunction.
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