摘要
目的探讨海南省儋州市恙虫病临床特征及并发器官损伤的危险因素。方法回顾性分析儋州市人民医院2017年4月至2018年4月收治的96例恙虫病患者的临床资料,依据患者是否出现器官损伤分为器官损伤组(n=45)及非器官损伤组(n=51)。分析96例恙虫病患者发病时间及临床特征,对比两组基础资料[性别、年龄、确诊时间、入院前发热时间、血钾、血钠、血沉、C反应蛋白、个人卫生习惯、住宅附近有无草地、合并疾病(高血压、糖尿病、高血脂)]的差异,多因素Logistic回归模型分析恙虫病并发器官损伤的危险因素。结果海南省儋州市恙虫病的发病时间以6、7、8月为主,在发病人群中占比分别为22.92%、37.50%、16.67%。临床症状以发热、畏寒为主,头痛、肌肉酸痛、咳嗽及咳痰次之;体征以特异性溃疡或焦痂、皮疹为主,淋巴结肿大、B超显示肝脏肿大及脾脏肿大次之。经单因素分析显示,两组性别、确诊时间、低热-高热、血钾、血钠、血沉、个人卫生习惯、住宅附近有无草地、合并疾病(高血压、糖尿病、高血脂)及特异性溃疡、焦痂或皮疹发生部位比较差异无统计学意义(P>0.05);器官损伤组年龄>60岁、入院前发热时间>13 d者显著多于非器官损伤组,差异有统计学意义(P<0.05);器官损伤组C反应蛋白水平(131.42±59.73)mg/L显著高于非器官损伤组(81.72±31.26)mg/L,差异有统计学意义(P<0.05)。经多因素Logistic回归分析显示,年龄、发热时间、C反应蛋白是恙虫病并发器官损伤的危险因素,差异均有统计学意义(OR=2.435、1.349、3.459,P<0.05)。结论海南省儋州市恙虫病患者并发器官损伤与年龄、发热时间、C反应蛋白相关,在恙虫病的预防和治疗中应当重视。
Objective To explore the epidemiological characteristics of tsutsugamushi disease and risk factors of organ damage in Danzhou city,Hainan province.Methods The clinical data of 96 patients with tsutsugamushi typhus admitted to Danzhou People′s Hospital from April 2017 to April 2018 were retrospectively analyzed.The patients were divided into organ injury group(n=45)and non-organ injury group(n=51).The onset time and clinical characteristics of 96 tsutsugamushi disease patients were analyzed.The differences of basic data between the two groups[sex,age,time of diagnosis,time of fever before admission,blood potassium,sodium,erythrocyte sedimentation rate,C-reactive protein,personal hygiene habits,grassland near residence,complications(hypertension,diabetes,hyperlipidemia)]were compared.Finally,the risk factors of tsutsugamushi disease complicated with organ damage were identified by multivariate logistic regression analysis model.Results The results showed that the onset time of tsutsugamushi disease in Danzhou city was mainly in June,July and August,accounting for 22.92%,37.50%and 16.67%,respectively.The results showed that the main clinical symptoms of tsutsugamushi disease in Danzhou city were fever and chills,followed by headache,muscle ache,cough and phlegm,specific ulcer or eschar,skin rash,lymph node enlargement,hepatomegaly and splenomegaly.The results of univariate analysis showed there were no significant differences in sex,time of diagnosis,low-high fever,blood potassium,blood sodium,erythrocyte sedimentation rate,personal hygiene habits,grassland near the residence,complications(hypertension,diabetes,hyperlipidemia)and specific ulcers,eschar or rash sites between the two groups(P>0.05).The age of>60 years old and the fever time of 13 d before admission in organ injury group was longer than that in non-organ injury group(P<0.05).The level of C-reactive protein in organ injury group(131.42±59.73)mg/L was significantly higher than that in non-organ injury group(81.72±31.26)mg/L(P<0.05).Multivariate logistic regression analysis confirmed that age,fever time and C-reactive protein were risk factors for organ damage in tsutsugamushi disease(OR=2.435,1.349,3.459,P<0.05).Conclusion Danzhou city,hainan province,the concomitant organ injury of tsutsugamushi patients was closely related to age,fever time and c-reactive protein.
作者
张文良
甘海忠
吴飞
ZHANG Wen-liang;GAN Hai-zhong;WU Fei(Danzhou People's Hospital,Danzhou,Hainan 571700,China)
出处
《热带医学杂志》
CAS
2020年第4期550-553,共4页
Journal of Tropical Medicine
关键词
恙虫病
器官损伤
危险因素
Tsutsugamushi disease
Organ damage
Risk factors
