非洲婴幼儿恶性疟疾65例临床分析

目的探讨非洲婴幼儿恶性疟疾临床特点、诊治方法及其转归。方法回顾性分析确诊为恶性疟疾65例（其中脑型疟19例）住院婴幼儿的临床资料。结果65例恶性疟疾婴幼儿的血涂片均见到恶性疟原虫；临床表现以发热（100％），呕吐32例（49．2％），腹泻23例（36．9％），咳嗽27例（41．5％），抽搐12例（18．5％），意识障碍19例（29．1％），贫血52例（80．0％），脾肿大46例（71．6％），肝肿大41例（63．1％），脑膜刺激征19例（29．1％）。65例均接受青蒿琥酯抗疟的综合治疗，治愈60例，死亡5例。结论婴幼儿恶性疟疾临床表现复杂多样化且不够典型，尽早诊断、及时治疗是改善本病预后的关键；青蒿琥酯是治疗疟疾安全、有效的首选药物。

Clinical analysis of 65 baby and infant cases with Plasmodium falciparum malaria

Objective To discuss the clinical features, diagnosis, treatment and prognosis of Plasmodium falciparum malaria in babies and infancts in Africa. Methods A retrospective analysis of 65 confirmed baby and infant falciparum malaria cases （including 19 severe cerebral malaria cases） in Africa. Results Plasmodium falciparum were detected from smears of 65 baby and infant falciparum malaria cases. Clinical manifestations were fever （100%）, vomiting in 32 cases （49.2%）, diarrhea in 23 cases （36.9 % ）, cough in 27 cases （41.5 % ）, convulsions in 12 cases （ 18.5 % ）, disturbance of consciousness in 19 cases （29. 1% ）, anemia in 52 cases （80.0%）, splenomegaly in 46 cases （71.6%）, hepatomegaly in 41 cases （63.1% ）, meningeal thorn Forward levy in 19 cases （29. 1%） . Sixty patients cured after treated wth artesunate and 5 cases died. Conclusion The clinical manifestations of baby and infants falciparum malaria were complicated and atypical, early diagnosis and treatment is essential for improvement of the prognosis; Artesunate is a safe and effective drug of choice for treatment falciparum malaria.