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【目的】探讨发热伴血小板减少综合征(severe fever with thromobocytopenia syndrome,SFTS)患者临床特征。【方法】采用回顾性调查、现场流行病学调查方法进行问卷调查,使用实时定量反转录聚合酶链反应(rRT-PCR)方法检测SFTS患者血液、排泄物中的SFTSV RNA。【结果】共43例患者,均为农民,其中男20例,女23例。大多数病例没有蜱叮咬史,但发病前2周均有树木、草丛等野外活动史或田间劳动史。主要临床症状多为发热、全身不适、肌肉酸痛、乏力、纳差、头痛、恶心、呕吐、咳嗽、咳痰、咽痛、腹痛、腹泻等;实验室检查主要是WBC、PLT降低,ALT、AST、CK、LDH升高,蛋白尿、血尿。39例患者血液标本SFTSV RNA检测阳性(90.70%)。所有病例的尿液、粪便、咽拭子标本未检测到SFTSV RNA。【结论】SFTS患者临床表现以发热伴白细胞、血小板减少和多脏器功能损害为主;患者血液中有SFTSV RNA存在;排泄物中虽未检测出SFTSV RNA,但仍需进一步深入研究。
【Objective】 To investigate the clinical features of patients with severe fever with thromobocytopenia syndrome (SFTS). 【Methods】 A retrospective survey and field epidemiological survey were conducted to investigate SFTSV RNA in blood and excretion of SFTS patients by real-time quantitative reverse transcription-polymerase chain reaction (rRT-PCR). 【Results】 A total of 43 patients were peasants, including 20 males and 23 females. Most cases have no history of tick bites, but the history of field activities such as trees and grasses, or the history of field labor are found two weeks before onset. The main clinical symptoms were fever, general malaise, muscle aches, fatigue, anorexia, headache, nausea, vomiting, cough, sputum, sore throat, abdominal pain, diarrhea, etc .; laboratory tests were mainly WBC, PLT decreased, ALT, AST , CK, LDH increased proteinuria, hematuria. SFTSV RNA was positive in blood samples from 90 patients (90.70%). No SFTSV RNA was detected in urine, stool, throat swab specimens in all cases. 【Conclusion】 The clinical manifestations of SFTS patients are fever with white blood cells, thrombocytopenia and multiple organ dysfunction; SFTSV RNA exists in the blood of patients; SFTSV RNA is not detected in the excrement, but further study is needed.