【摘要】 目的分析恙虫病并发中毒性肝炎患者不同年龄组的临床特征及诊疗措施。方法对我院70例恙虫病并发中毒性肝炎患者的临床资料进行回顾性分析,分为中青年组33例(21~59岁),老年组37例(60~83岁),并比较两组患者的临床症状、肝功能损害程度、焦痂分布部位、外斐试验阳性率及治疗预后。结果 1中青年组与老年组临床症状比较发现老年组肝肿大、脾肿大、皮肤巩膜黄染及恶心呕吐等表现较中青年组明显,P<0.05;2两组肝功能受损程度比较发现老年组肝功能各项指标受损程度较中青年组严重,差异均具有统计学意义(P<0.05);3两组外斐试验阳性率均较低,差异无统计学意义(P>0.05);4两组经过抗立克次体及保肝等治疗后大部分患者痊愈,差异无统计学意义(P>0.05)。结论恙虫病并发肝功能受损较常见,少数患者出现严重损害,亦可导致死亡,尤其老年患者,尽早诊断及合理治疗,有助于缩短病程,降低死亡率。更多还原

【Abstract】 Objective To analyze clinical characteristic and treatment measures of the different age patients with tsutsugamushi disease complicated with toxic hepatitis. Methods Clinical data of 70 cases with tsutsugamushi disease complicated with toxic hepatitis in our hospital were retrospectively analyzed, and designed the young group of 33 cases(21~59 years old) and elderly group of 37 cases(60~83 years old). Compard clinical symptoms, liver function damage degree, eschar distribution area, outside the Felix test positive rate and treatment outcome of two groups. Results 1 Compared with the young group, hepatomegaly, splenomegaly, skin yellowing sclera and nausea and vomiting of elderly group were more obvious. The difference had statistical significance(P<0.05). 2The liver function damage degree of elderly group was heavier than the young group. The difference had statistical significance(P<0.05). 3The Felix test positive rate were lower in both two groups. There were not statistical significance difference(P>0.05). 4The two groups of patients after the treatment of rickettsial and protect live,eventually the majority of patients recovered after treatment. There were not statistical significance difference(P >0.05).Conclusion Tsutsugamushi disease complicated with hepatic damage is common, a few patients with severe damage and easily death, especially in elderly patients. So the early diagnosis and proper treatment can shorten the course of the disease and reduce mortality.更多还原