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目的研究塞拉利昂弗里敦地区老年埃博拉病毒病(Ebola virus disease,EVD)患者的临床特点。方法选取我国解放军援塞医疗队2014年10月—2015年3月收治的老年(>60岁)EVD确诊患者21例(老年组)进行回顾性分析,研究其临床特点。选取同期收治的非老年EVD患者235例(非老年组)作为对照。结果老年组病毒载量与非老年组差异无统计学意义。老年组主要临床表现依次为发热、乏力、纳差、腹痛、头痛、咳嗽、关节痛、恶心呕吐、腹泻、肌肉痛、胸痛和结膜炎。老年组腹痛(85.7%)和精神错乱(23.8%)的发生率均高于非老年组[64.3%(P=0.047)和8.9%(P=0.047)],关节痛(61.9%)的发生率低于非老年组(83.0%)(P=0.018)。老年组病死率(33.3%)与非老年组(39.1%)差异无统计学意义,老年组入院后至死亡的平均死亡时间[(3.0±1.4)d]与非老年组[(2.3±1.7)d]差异亦无统计学意义。结论老年EVD患者临床表现及预后与非老年EVD患者类似,但仍具有其自身特点,这对诊断和治疗具有重要的指导意义。
Objective To investigate the clinical features of elderly Ebola virus disease (EVD) in Freetown, Sierra Leone. Methods Twenty-one elderly patients (aged> 60 years old) diagnosed with EVD in our hospital from October 2014 to March 2015 were retrospectively analyzed and their clinical features were studied. A total of 235 non-elderly EVD patients (non-elderly) were enrolled as controls. Results There was no significant difference in the viral load between the elderly group and the non-elderly group. The main clinical manifestations of the elderly group followed by fever, fatigue, anorexia, abdominal pain, headache, cough, joint pain, nausea and vomiting, diarrhea, muscle pain, chest pain and conjunctivitis. The incidence of abdominal pain (85.7%) and delirium (23.8%) in the elderly group were significantly higher than those in the non-elderly group [64.3% (P = 0.047) and 8.9% (P = 0.047)] and the incidence of arthralgia (61.9% Lower than the non-elderly group (83.0%) (P = 0.018). There was no significant difference between the elder group (33.3%) and the non-elder group (39.1%). The mean death time from death to death in the elderly group [(3.0 ± 1.4) d] d] the difference is not statistically significant. Conclusion The clinical manifestations and prognosis of elderly patients with EVD are similar to those of non-elderly patients with EVD, but still have their own characteristics, which have important guiding significance for diagnosis and treatment.