摘要
目的分析86例黑热病患者相关临床资料,提高黑热病诊治水平。方法回顾性分析86例黑热病的流行情况、临床表现、实验室检查、诊治情况及转归。结果四川地区有黑热病流行疫区,发热、肝脾和淋巴结肿大、全血细胞减少及血浆球蛋白明显增高为黑热病主要临床表现。予葡萄糖酸锑钠正规治疗,总治愈率为95.3%(82/86),脾切除2例(2.3%),复发1例(1.2%),初始误诊率达30.2%。好转后自动出院3例。结论黑热病无特异的临床表现,误诊率较高,对疑诊患者应及早行骨髓涂片或组织活检,查找利什曼原虫无鞭毛体,结合39 ku蛋白重组抗原(rk39)检测,有利于及时诊治,减少并发症。葡萄糖酸锑钠仍是治疗黑热病安全、有效的首选药物。
Objective To improve the diagnosis and treatment based on the retrospective clinical analysis of 86 patients with leishmaniasis, an endemic disease caused by various species of Leishrnania. Methods The data of 86 consecutive patients with visceral leishmaniasis and lymph node leishmaniasis were retrospectively reviewed, including epidemiological data, clinical man- ifestations, laboratory features, diagnosis, therapeutic procedures and prognosis. Results There were specific endemic zones of leishmaniasis in Sichuan province. The main clinical symptoms and signs in the initial evaluation were; fever （100%）, splenomegaly （100%）, enlarged lymph nodes with hepatosplenomegaly （58.1%）. All patients were treated with sodium pentavalent antimony gluconate （SPAG）. About 95.3% （82/86） of the patients were cured, 3.5% （3/86） improved, and 1.2% （1/86） relapsed. Sptenotomy was carried out for 2.3% （2/86） of the patients. The misdiagnosis rate was 30.2%. Conclusions Visceral leishmaniasis has no specific manifestations and is easily misdiagnosed. If leishmaniasis is suspected, bone marrow biopsy and smear examination, lymph node biopsy, rk-39 strip test for visceral leishmaniasis pathogen should be done to improve the outcome. SPAG is the first choice for leishmaniasis chemotherapy.
出处
《中国感染与化疗杂志》
CAS
2009年第4期241-243,共3页
Chinese Journal of Infection and Chemotherapy
关键词
黑热病
临床分析
误诊
leishmaniasis； clinical analysis； misdiagnosis
