发热伴血小板减少综合征人人间传播患者临床特征分析

发布时间：2018-03-20 13:40

  本文选题：发热　切入点：血小板减少　出处：《中国全科医学》2017年06期 　论文类型：期刊论文

【摘要】：背景发热伴血小板减少综合征(SFTS)人人间传播的患者报道越来越多,但缺乏详尽的临床特征总结。目的总结我国SFTS人人间传播患者的危险因素、临床表现、实验室检查特点,提高临床医生对SFTS人人间传播的认识,减少SFTS人人间传播及误诊误治。方法检索2007年1月—2016年3月Medline、Pub Med、Embase、Google Scholar Databases、相关期刊论文、万方全文数据库、维普全文数据库,采用高级检索,检索项均为全部字段,以"发热伴血小板减少综合征""人人间传播""severe fever with thrombocytopenia syndrome"和"person-toperson transmission"为检索词,下载检索到的全部文献,仔细阅读所有文献的全文,剔除重复收录、重复发表、同一单位或个人的重复报道的文献。回顾性分析符合纳入标准的56例SFTS人人间传播患者的临床资料。结果检索到符合标准的文献7篇,共56例患者,其中原发患者8例,继发患者48例。继发患者潜伏期为6~15 d;45例有接触原发患者血液或血性分泌物的危险因素,2例可疑经空气传播,1例经蜱虫传播;主要临床表现为发热、寒战、腹泻,其次为恶心、呕吐、出血、腹痛、咳嗽、皮疹、结膜充血、头痛、肌痛等。患者均出现白细胞计数及血小板计数下降,血清丙氨酸氨基转移酶及血清天冬氨酸氨基转移酶升高;其余实验室检查结果异常包括乳酸脱氢酶升高、活化部分凝血活酶时间延长、肌酐升高、肌酸激酶升高、出现蛋白尿及血尿。结论 SFTS人人间传播得到证实,主要通过接触患者血液或血性分泌物传播,有可疑空气传播。大部分为显性感染,少部分为隐性感染。人人间传播的潜伏期比蜱虫叮咬传播的潜伏期短,临床症状轻,病死率低,早期诊治预后良好。
[Abstract]:Background there are more and more reports of patients with fever associated with thrombocytopenia syndrome transmitted from human to human, but lack of detailed summary of clinical features. Objective to summarize the risk factors, clinical manifestations and laboratory findings of patients with human transmission of SFTS in China. Methods to improve the clinical doctors' understanding of human SFTS transmission, reduce SFTS human transmission and misdiagnosis and mistreatment. Methods the contents of Medline Pub Medbase Scholar Database, China Journal Full-text Database, Wanfang Full-text Database and Weip Full-text Database were searched from January 2007 to March 2016. Using advanced retrieval, all the search items were all fields, "severe fever with thrombocytopenia syndrome" and "person-toperson transmission" and "severe fever with thrombocytopenia syndrome" and "person-toperson transmission" were used as the key words, and the full text of all the literatures was carefully read. The clinical data of 56 SFTS human-to-human transmission patients who met the inclusion criteria were retrospectively analyzed. Among them, 8 cases were primary patients, 48 cases were secondary patients. The latent period of secondary patients was 615 days, 45 cases had exposure to blood or blood secretion of primary patients, 2 cases were suspected to be transmitted by air, 1 case was transmitted by ticks, the main clinical manifestations were fever and shivering. Diarrhea, followed by nausea, vomiting, bleeding, abdominal pain, cough, rash, conjunctival congestion, headache, myalgia, etc. The levels of serum alanine aminotransferase and aspartate aminotransferase were increased. The other laboratory findings included the increase of lactate dehydrogenase, the prolongation of activated partial thromboplastin time, the increase of creatinine, and the increase of creatine kinase. Conclusion the human transmission of SFTS is confirmed mainly through contact with blood or blood secretions of the patient, and there is suspicious air transmission. Most of them are dominant infections. The latent period of human transmission was shorter than that of tick bite transmission, the clinical symptoms were mild, the mortality rate was low, and the early diagnosis and treatment had a good prognosis.
【作者单位】： 中国医科大学附属第一医院传染科;
【基金】：辽宁省自然科学基金资助项目(2014021063) 沈阳市科学技术项目计划(F13-220-9-23)
【分类号】：R511
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本文编号：1639319