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目的探讨近年来上海市疟疾病例的临床特征和发病趋势,为临床诊断和治疗提供依据。方法收集2006～2009年上海市38例外周血涂片阳性疟疾病例资料,进行镜下形态学分型,对其流行病学特征、临床表现、辅助检查(肝功能、血常规)、治疗效果(治愈例数和再燃例数)和特殊病例进行分析。结果 38例中20例为境外输入,主要来自非洲国家,外省市输入12例,本市散发仅为6例。病例临床表现较为多样性,大部分无明显的规律性发热,查外周血红细胞、血小板、血红蛋白、红细胞比积不同程度地降低,血清乳酸脱氢酶、总胆红素、直接胆红素不同程度升高。间日疟与恶性疟患者血红蛋白、天冬氨酸氨基转移酶、乳酸脱氢酶和总胆红素存在显著性差异。青蒿琥酯联合伯氨喹、氯喹疗法较青蒿素单一疗法和氯喹、伯氨喹联合疗法治疗效果好。结论上海市疟疾病例以输入性为主。建议相关部门注意对外来人员的普查并制定相应的预防措施。临床治疗采用以青蒿素为基础的联合治疗(ACT)方案。
Objective To explore the clinical features and trends of malaria cases in Shanghai in recent years and provide the basis for clinical diagnosis and treatment. Methods The data of 38 cases of peripheral blood smear-positive malaria in Shanghai from 2006 to 2009 were collected and analyzed by microscopic morphological classification. The epidemiological characteristics, clinical manifestations, auxiliary examination (liver function, blood routine) and treatment effect Cases and the number of cases of reburning) and special cases were analyzed. Results Among the 38 cases, 20 cases were imported overseas, mainly from African countries, 12 cases were imported from other provinces and cities, and only 6 cases were distributed in this city. The clinical manifestations of cases were quite diverse. Most of them had no regular regular fever. The peripheral blood red blood cells, platelets, hemoglobin and hematocrit were decreased to varying degrees. The levels of serum lactate dehydrogenase, total bilirubin and direct bilirubin were different Rise. There was a significant difference in hemoglobin, aspartate aminotransferase, lactate dehydrogenase and total bilirubin in patients with Vivax and Plasmodium falciparum. Artesunate combined with primaquine, chloroquine therapy than artemisinin monotherapy and chloroquine, primaquine combination therapy is effective. Conclusion The malaria cases in Shanghai are mainly imported. It is recommended that relevant departments pay attention to the census of foreign workers and make corresponding preventive measures. Clinical treatment with artemisinin-based combination therapy (ACT) program.