山西省阳泉市17例黑热病患者临床分析

来源 :中华地方病学杂志 | 被引量 : 0次 | 上传用户:yunkang0820
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目的:探讨山西省阳泉市黑热病患者流行特征、临床特点及治疗效果,提高对黑热病的认知。方法:采用回顾性分析方法,收集2018、2019年山西省阳泉市17例黑热病患者的临床资料,整理分析流行病学特点、临床诊断和首诊情况、临床表现、实验室和影像学检查结果、治疗及转归等。结果:17例患者均来自山西省阳泉市,其中男性15例、女性2例。临床主要表现为长期不规则发热(17例)、贫血(13例)、脾肿大(16例)。血常规主要表现为白细胞计数下降(14例)、贫血(13例)、血小板计数降低(10例)。14例患者进行rk39免疫层析试纸条检测,检测阳性率为100.00%(14/14)。9例患者进行骨髓穿刺涂片检查,利杜小体阳性7例。17例患者均采用葡萄糖酸锑钠(简称锑剂)10 d疗法,治愈率为88.24%(15/17),复发率为11.76%(2/17)。结论:黑热病临床表现不典型,易误诊。对疑诊患者应早期进行血清学联合骨髓穿刺涂片检查。锑剂仍是治疗黑热病有效、较安全的药物。“,”Objective:To explore the epidemic characteristics, clinical features and therapeutic effects of Kala-azar in Yangquan City, Shanxi Province in recent years, and to improve the cognition of Kala-azar.Methods:The clinical data of 17 adult cases of Kala-azar in Yangquan City, Shanxi Province in 2018 and 2019 were collected by retrospective analysis method, the epidemiological characteristics, clinical diagnosis and first diagnosis, clinical manifestations, laboratory and imaging examination, treatment and prognosis of the patients were sorted and analyzed.Results:All 17 patients were from Yangquan City, Shanxi Province, including 15 males and 2 females. The main clinical manifestations were long-term irregular fever (17 cases), anemia (13 cases) and splenomegaly (16 cases). The main manifestations of blood routine included decreased white blood cell count (14 cases), anemia (13 cases), and decreased platelet count (10 cases). The positive rate of rk39 immunochromatographic strip test was 100.00% (14/14). Nine patients underwent bone marrow puncture smear examination, 7 patients were positive for Leishman-Donovan bodies. All patients were treated with sodium pentavalent antimony gluconate (hereinafter referred to as antimonials) for 10 days, the cure rate was 88.24% (15/17), and recurrence rate was 11.76% (2/17).Conclusions:The clinical manifestations of Kala-azar are not typical, and it is easy to be misdiagnosed. Early examination of bone marrow puncture smear and serum antibody should be carried out for suspected patients. Antimonials is still a safe and effective drug for treating Kala-azar.
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1951年生。山东省莱阳市人。毕业于上海师范大学。山水师从任书博、陆俨少先生。现为上海中国画院创作研究室主任、一级美术师,中国美术家协会会员。 Born in 1951. Laiyang
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