佛山地区恙虫病111例临床分析

目的总结恙虫病的新特点和诊断、治疗经验。方法随机抽取恙虫病111例，包括普通型97例，重型14例，对流行病学及临床资料进行回顾性分析。结果5-9月间发病者占78．4％（87／111），有明显的季节性；〉60岁占39．6％（44／111），22．5％（25／111）出现3个以上器官损害，其中有48％（12／25）年龄〉60岁；住院时间与退热时间、白蛋白之间差异有统计学意义（P〈O．05）；重型组白蛋白、血小板、退热时间、丙氨酸氨基转移酶、白细胞水平较普通型组差异有统计学意义（P〈0．05）；不同抗感染药物组的退热时间、住院时间有显著差异，治愈率无差异；氯霉素组35．7％（25，70）出现粒细胞减少，其它组无明显不良反应。结论恙虫病发病呈高龄化，临床表现趋向多样化、复杂化；自蛋白、血小板、退热时间、丙氨酸氨基转移酶、白细胞水平与病情的严重程度有关；氯霉素、多西环素序贯治疗效果好且副作用少。

Clinical analysis of 111 tsutsugamushi disease patients in Foshan city.

Objective To analyze new features of tsutsugamushi disease and experience of diagnosis and treatment. Methods The 111 tsutsugamushi disease patients, including 97 cases of common type and 14 cases of severe type were randomly selected.The epidemiological and clinical materials were analyzed retrospectively. Results The incidence between 5-9 month was78.4%. 39.6% of the patients were over 60 years old. Multiple organ function lesions were found in 22.5% of the patients, and 48% of them were over 60 years old. The hospitalization time of the patients were markedly correlated with defe~escence time and serum Alb according to multiple linear regression analysis （P〈0.05）. The level of Alb, PLT, defervescence time, ALT,WBC of severe and common type group were respectively significantly different（P〈0.05） But no significant difference in cure rate was observed in different antibiotics groups. Neutropenia wasnoticed in 35.7% of the patients in chloromycetin group only. Conclusions The aging structure makes tsutsugamushi disease varied and complicated. The level of Alb, PLT, defervescence time, ALT,WBC are related to severity. Chloremycetin and doxycycline are effective on tsutsugamushi disease with less side effects.