【摘要】 目的探讨输入性恶性疟疾的流行病学及临床特点。方法收集2007年1月至2013年12月浙江大学医学院附属第一医院及浦江县人民医院收治的输入性恶性疟疾患者共37例,对其流行病学资料、临床表现、实验室检查、诊治情况等进行回顾性分析。结果输入性疟疾病例全年散发,无明显季节性。37例患者均有疟疾流行区居住史,以男性为主(36例)。所有患者均有发热,以中高热为主,伴有消化道反应(7例)、意识改变(5例)、皮肤巩膜黄染(10例)、贫血(12例)、肝肿大(2例)、脾肿大(4例)、腹水(1例)等表现。实验室检查:白细胞计数异常20例,血小板下降30例,C反应蛋白(CRP)升高25例,肝肾功能异常。明确诊断后均予抗疟及综合治疗。在治疗48~96 h后患者体温均恢复正常;血小板下降者在治疗后第3天均开始回升,第7天时恢复正常者28例(93.3%);所有患者均治愈出院。结论有疟疾流行区居住史的发热患者,尤其是血小板减少、CRP增高者应高度怀疑恶性疟疾,动态检测血小板的变化对其早期诊断及疗效判断具有重要意义。更多还原

【Abstract】 Objective To investigate the epidemiology and clinical features of imported falciparum malaria. Methods A total of 37 imported falciparum malaria patients hospitalized in the First Affiliated Hospital of Zhejiang University and People’s Hospital of Pujiang County between January 2007 and December 2013 were retrospective studied. The epidemiological data,clinical features, auxiliary examination results and treatment condition of the patients were collected and analyzed. Results The pafalciparum malaria can be found at the whole year,without obvious peak season of paroxysm. All the patients had been the malaria endemic areas and also had a fever, mostly medium or high fever, accompany with gastrointestinal reaction(7patients), altered state of consciousness(5 patients), skin yellowing sclera(10 patients), anemia(12 patients), hepatomegaly(2 patients), splenomegaly(4 patients), and ascites(1 patient).According to the laboratory tests, white blood cells in 20 cases were abnormal, platelet declined in 30 cases, and C reactive protein increased in 25 cases. There were 27 cases of abnormal liver function, 6 cases of abnormal renal function, and 10 cases of abnormal urine protein. All the patients received comprehensive therapy, including artesunate treatment. The body temperature of all the patients declined to be normal within 48- 96 hours after anti-malaria treatment and blood platelet began to increase three days after the treatment. Twenty-eight patients recovered on the 7th day. All the patients were recovered well and discharged from the hospital. Conclusion Fever patients from malarious areas, especially those who accompany with peripheral blood platelet reduction and CRP increase, should be suspected as falciparum malaria. Dynamic change of platelet is meaningful in diagnosis of malaria at the early phase and curative effect evaluation.更多还原