摘要
目的探讨自2002年5月至2003年11月广州及周边地区暴发流行登革热(DF)的临床特征。方法对我院收治的1032例DF的临床资料进行回顾性分析,用细胞培养和逆转录聚合酶链反应(RTPCR)进行登革病毒(DEV)分离和鉴定。结果主要临床表现为发热(100%)、头痛(90.9%)、全身肌痛(68.4%)、骨痛(48.8%)、疲乏(79.3%)、皮疹(60.1%)、束臂试验阳性(45.3%);白细胞及血小板减少分别占63.3%和60.8%;丙氨酸转氨酶(ALT)升高(71.8%)、天门冬氨酸转氨酶(AST)升高(86.9%)、乳酸脱氢酶(LDH)升高(44.7%)、肌酸磷酸激酶(CK)升高(31.3%)和低钾血症(19.2%)。临床分型仅2例为登革出血热(DHF),其余均为典型DF。从54份发病5d内急性期患者的血清标本中分离病毒19份,经RTPCR和基因测序证实为DEV-Ⅰ型感染;检测30份急性期血清DEVRNA阳性率为83.3%。结论近年广州地区流行的登革热为DEV-Ⅰ型所致。多数病例符合典型登革热的临床表现,肝损害较多,部分病例出现低钾血症,DHF发生率低。
Objective To explore the clinical and laboratory characteristics of patients with dengue fever (DF) in Guangzhou from May 2002 to November 2003. Methods Clinical data from 1032 patients with DF were retrospectively analyzed. Dengue virus (DEV) were isolated by cell culture and typed by reverse transcriptase polymerase chain reaction (RT-PCR). Results Patients ranged from 55 day to 91 year old [average (34.7±13.2) years]. The common manifestations included fever (100%), headache (90.9%), myalgia (68.4%), bone soreness (48.8%), fatigue (79.3%), skin rash (60.1%), positive tourniquet test (45.3%), leukopenia (63.3%), thrombocytopenia (60.8%), respectively. Other common findings were elevated alanine aminotransferase (71.8%), elevated aspartate aminotransferase (86.9%), elevated lactase dehydrogenase (44.7%), elevated creatinine kinase (31.3%) and hypopotassemia (19.2% ). Only 2 patients were clinically diagnosed as dengue haemorrhagic fever (DHF), the others were all diagnosed as common DF. DEV were isolated from 19 of 54 serum samples of patients within 5 days of the onset and then identified as DEV type Ⅰ. Serum DEV RNA was detected by RT-PCR in 25 of 30 patients(83.3%). Conclusions The epidemic of dengue fever in Guangzhou in recent years were caused by DEV-Ⅰ. Most patients are classic dengue fever but with high percentage of hepatic injury and hypopotassemia. The incidence of DHF was very low.
出处
《中华传染病杂志》
CAS
CSCD
北大核心
2005年第2期121-124,共4页
Chinese Journal of Infectious Diseases
基金
广州市重点科技攻关计划项目(2004Z2E0212)
