温州市157例甲型副伤寒特征分析

目的了解温州市甲型副伤寒的流行规律、临床特征和耐药性特点,为今后防治工作提供科学依据。方法病例来自1998年1月-2009年12月温州医学院附属第一医院收治的甲型副伤寒住院病人。结果共收集157例甲型副伤寒患者。发病年龄主要集中在20-50岁人群中,约占80%。2001-2003年为发病高峰,尤其是2003年,病例数为85例。冬春季节是甲型副伤寒的好发月份。甲型副伤寒高热多见,超过39℃的病例占80.3%。没有发现1例玫瑰疹。合并基础疾病的占33.8%。平均住院时间为17.68 d。白细胞计数介于（2-8）×10^9/L占88.5%,嗜酸粒细胞消失占51.7%。红细胞沉降率升高不明显,小于60 mm/1 h末占88.57%。中毒性肝炎的发生率为90.2%,但肝功能损害程度相对较轻,丙氨酸氨基转移酶≤3倍正常值占84.3%。肥大反应阳性率7.7%。除头孢哌酮、头孢呋辛、复方磺胺甲噁唑、氨苄西林耐药性稍高外,其他抗菌药物敏感性均在90%以上。结论温州市的甲型副伤寒具有自身的流行规律、临床特征和药敏试验特点,本研究对甲型副伤寒的早期诊断和合理治疗具有指导作用。

A study on features of paratyphoid A in Wenzhou city,1998-2009

Objective To explore epidemic rule,clinical characteristics and drug resistance of paratyphoid A,and to provide scientific basis for prevention and control of paraphoid A in the future.Methods All paratyphoid A patients visited the First Affiliated Hospital of Wenzhou Medical College from January 1998 to February 2009 were included in the study.Results A total of 157 cases were confirmed during the period.Adults aged 20-50 years accounted for 80% of all cases.Years of 2001 to 2003 were the peak of incidences.85 cases were found in 2003.Winter and spring were epidemic seasons of paratyphoid A.Patients usually had fever and 80.3% of which had temperature higher than 39℃.Roseola was not observed.Cases with underlying diseases accounted for 33.8% and average length of hospitalization was 17.68 days.88.5% of patients had white blood cell counts ranged from 2×10^9/L to 8×10^9/L.Eosinophils disappeared in 51.7% of patients.88.5% of patients had ESR less than 60mm/h.90.2% of cases had mild toxic hepatitis,84.3% of which had elevated alanine aminotransferase,but less than 3 times of the normal upper limit.Most antibiotics were effective,however,drug resistance strains were observed in cefoperazone,cetrimoxazole and ampicillin.Conclusion Paratyphoid A in Wenzhou city had its own epidemic rules,clinical characteristics and drug sensitivity.