输入性疟疾90例临床特征分析

目的了解输入性疟疾的临床特点,抗疟疾药治疗效果,为临床诊治提供参考依据。方法对2008年1月至2018年6月笔者所在医院感染病科收住的90例非洲务工疟疾患者的临床表现、实验室检查、治疗方案进行回顾性分析。结果 90例患者均有发热现象,伴畏寒寒战84例,贫血30例,脾肿大24例。出现并发症57例,其中急性肝损害18例,急性血管内溶血15例,急性肾衰竭6例,脑型疟疾9例,肺病变9例。血小板减少有66例,其中严重减少18例,淋巴细胞减少60例,出现黄疸者共63例,以间接胆红素升高为主,ALT升高42例。血检疟原虫阳性率57例,其中间日疟15例,恶性疟18例,分型不详24例,根据情况选用不同抗疟药物治疗,所有病例最终均有效控制症状。结论输入性疟疾临床症状典型,有急性肝损害、急性血管内溶血、急性肾衰竭、脑型疟疾及肺病变等常见并发症。血检疟原虫阳性率较高。血小板减少较普遍且较严重,淋巴细胞比例严重减少者病情重。肾损害比例高。常用抗疟药物能有效控制症状。

Clinical analysis of 90 cases of input malaria

Objective To understand the clinical characteristics of imported malaria and the therapeutic effect of antimalarials,so as to provide reference for clinical diagnosis and treatment.Methods A retrospective analysis was made on the clinical manifestations,laboratory tests and treatment of 90 cases of malaria among African migrant workers admitted to our hospital from January 2008 to June 2018.Results There were fever in 90 cases,chills and chills in 84 cases,anemia in 30 cases and splenomegaly in 24 cases.Complications occurred in 57 cases,including 18 cases of acute liver injury,15 cases of acute intravascular hemolysis,6 cases of acute renal failure,9 cases of cerebral malaria and 9 cases of lung disease.There were 66 cases of thrombocytopenia,including 18 cases of severe thrombocytopenia,60 cases of lymphocytopenia,63 cases of jaundice,mainly indirect bilirubin elevation,42 cases of ALT elevation.The positive rate of Plasmodium falciparum in blood test was 57 cases,including 15 cases of vivax malaria,18 cases of falciparum malaria and 24 cases of unknown typing.Conclusion The typical clinical symptoms of imported malaria are acute liver damage,acute intravascular hemolysis,acute renal failure,cerebral malaria and lung disease.The positive rate of Plasmodium in blood was higher.Thrombocytopenia is more common and serious,and the proportion of lymphocytes is seriously reduced.The proportion of renal damage is high.Commonly used antimalarial drugs are effective in controlling symptoms.