59例成人麻疹临床分析

目的通过对成人麻疹的临床资料分析,探讨成人麻疹的流行病学及临床特征。方法回顾性分析蚌埠医学院第一附属医院2012年7月—2013年6月收治的59例成人麻疹病例的发病季节、年龄、地区分布、临床症状、体征及实验室检查特点和临床转归。结果男性15名,女性44名,男∶女=1∶2.93,其中孕妇13人（22.03%）,产妇3人（5.08%）,发病年龄以青壮年为主,20～39岁50人（84.75%）,成人麻疹全年均有发病,2—4月为发病高峰季节,发病人群以农村患者居多（79.66%）,59例（100%）出现发热,39～41℃46例（77.97%）,平均热程（8.58±2.59）d;51例（86.44%）出现呼吸道卡他症状,59例（100.00%）出现皮疹,平均以发病（4.46±1.71）d出疹,59例（100.00%）有口腔麻疹黏膜斑。血清麻疹病毒IgM抗体检测,阳性率为49.82%。并发症中肝功能损害39例（66.10%）,支气管炎及支气管肺炎32例（54.24%）,消化道出血2例（3.39%）,脑炎1例（1.69%）,喉炎1例（1.69%）。孕妇感染者发生流产及死胎3例（23.08%）,重症者2例（3.39%）,59例（100.00%）均痊愈。结论成人麻疹临床症状典型,并发支气管炎和肝功能损害最为常见,孕妇感染者流产发生率较高,但重症患者少,临床预后良好。

Clinical analysis of 59 cases of measles in adults

Objective To explore the epidemiological and clinical characteristics of Measles virus infection in adults in Bengbu city. Methods 59 adults with measles in our hospital were enrolled in this study. The clinical data including onset seasons,age,local distribution,clinical symptoms,signs,results of laboratory tests and clinical outcome were analyzed retrospectively. Results There were 15 male patients and 44 female patients with a ratio of 1∶ 2. 93,which including 13 pregnant women（22. 03%） and 3 parturient（5. 08%）. The young adults aged 20 to 39 years old（50 people accounted for84. 75%） were the common group. Measles in adults were seen in different seasons of the year,especially from February to April. The incidence in the rural areas was high（79. 66%）. 59 cases（100. 00%） developed symptom of fever： temperature of 46 patients（77. 97%） was 39 to 41 degrees Celsius with an average duration of（8. 58 ± 2. 59） days. 51 cases（86.44%） were with catarrhal symptoms of the respiratory tract;59 cases（100.00%） were with skin rashes which were last（4. 46 ± 1. 71） days;all cases were with Koplik spots. The positive rate of serum Measles virus IgM was 49. 82%.The complications included liver function damage in 39 cases（66. 10%）,bronchitis and bronchopneumonia in 32 cases（54.24%）,gastrointestinal bleeding in 2 cases（3. 39%）,encephalitis in 1 case（1. 69%）,and laryngitis in 1 case（1.69%）. There were 3 cases（23.08%） of abortion and stillbirth in pregnant women,in which 2 cases（3.39%） were severe,and all cases recovered after the treatment. Conclusion Measles virus infection in adults is with typical clinical symptoms. The liver function damage and bronchitis are the most common complications. Measles infection in pregnant women easy leads to abortion. The serious cases are less in adults and the prognosis of patients is good.