62例婴幼儿重型麻疹临床及流行病学特征

目的探讨婴幼儿重型麻疹的临床及流行病学特点。方法回顾性分析62例重型麻疹婴幼儿的临床资料。结果 62例重型麻疹患儿中,年龄9月龄42例(67.74%),其中37例(88.10%)未接种麻疹疫苗;发病月份为2~5月,其中3~4月41例(66.13%)。临床表现均有发热和皮疹,口腔黏膜斑50例(80.65%),卡他症状48例(77.42%),结膜炎49例(79.03%),早期有饮水呛咳病史47例(75.81%);合并肺炎59例(95.16%),急性喉炎22例(35.48%),电解质紊乱13例(20.97%),急性呼吸窘迫综合征和肝功能损害各6例(9.68%),气胸5例(8.06%),心肌损害3例(4.84%),呼吸衰竭和中毒性脑病各2例(3.23%),麻疹脑炎和胸腔积液各1例(1.61%)。治愈41例,好转19例,死亡1例,放弃治疗1例。结论该组重型麻疹婴幼儿以9月龄且未接种麻疹疫苗的婴儿为主;早期有饮水呛咳史;发病月份多为3~4月;肺炎仍是婴幼儿麻疹的主要并发症。

Clinical and epidemiological characteristics of severe measles in 62 infants

ObjectiveTo explore the clinical and epidemiological characteristics of severe measles in infants. MethodsClinical data of 62 infants with severe measles were analyzed retrospectively. ResultsOf 62 infants with severe measles, 42 (67.74%) were aged < 9 months, of whom 37（88.10%）were not vaccinated against measles. The onset months were February May, 41 cases (66.13%) were found in March April.  All patients had fever and skin rash, the rates of other symptoms and complications were as follows : oral leukoplakia 80.65%（n=50）, Catarrh symptom 77.42%（n=48）, conjunctivitis 79.03%（n=49）, history of choked water cough 75.81%（n=47）, pneumonia 95.16%（n=59）, acute laryngitis 35.48% (n=22), electrolyte disorder  20.97%（n=13）, acute respiratory distress syndrome 9.68%（n=6）, liver function damage 9.68%（n=6）, pneumothorax 8.06% （n=5）,myocardial damage 4.84% （n=3）, respiratory failure 3.23% （n=2）, toxic encephalopathy 3.23%（n=2）, measles encephalitis 1.61% （n=1）, and pleural effusion  1.61%（n=1）. Of all cases, 41 cases were cured, 19 cases improved, 1 case died, and 1 case gave up treatment.  ConclusionThese severe measles cases occurred mainly in infants aged<9 months and were not vaccinated against measles; infants had history of choked water cough; the main onset months were March April ; pneumonia was still a predominant complication of infant measles.