【摘要】 目的探讨2020年清远地区恙虫病临床特征及器官损伤相关因素。方法对2020年1—9月该院128例恙虫病患者临床资料进行回顾性分析,观察其临床特征及器官损伤相关因素。结果 128例患者中临床症状包含发热(100.00%)、头痛(46.88%)、咳嗽(42.97%)、咳痰(25.00%)、消化道出血(0.78%)、胸闷(10.94%)、胃肠反应(45.31%)、神志障碍(7.81%)、皮肤焦痂(98.44%)、淋巴结大(76.56%)、皮疹(48.44%)、肝大(17.94%)、胸腔积液(10.94%)、黄疸(20.31%)及腹水(7.81%)等,多数患者白细胞正常(67.19%)、嗜酸粒细胞减少(83.59%)、CRP升高(96.09%)、ALT或AST升高(92.97%)及心肌酶升高(78.91%),器官损害以肝功能损伤偏多(92.97%),器官损伤与患者年龄(OR=0.814,95%CI:0.773～0.855)、入院前发热时间(OR=1.346,95%CI:0.056～6.873)成正相关关系(waldχ~2=5.673、3.474,P<0.05);器官损伤与CRP (OR=2.541,95%CI:1.208～3.364)、热峰(OR=3.736,95%CI:2.862～4.153)没有相关性(waldχ~2=35.370、6.425,P>0.05)。结论恙虫病临床症状及体征较为多样,常累及人体内多个系统,其中以发热、焦痂为最具诊断价值的症状及体征,嗜酸粒细胞减少也可作为恙虫病诊断标准,器官损伤以肝功能损伤为典型,入院前年龄与发热时间与器官功能损伤有一定联系。更多还原

【Abstract】 Objective To investigate the clinical characteristics and organ injury related factors of scrub typhus in Qingyuan area in 2020. Methods The clinical data of 128 patients with tsutsugamushi in the hospital from January 2020 to September 2020 were retrospectively analyzed to observe their clinical features and organ damage related factors. Results The clinical symptoms of 128 patients included fever(100.00%), headache(46.88%), cough(42.97%), expectoration(25.00%),gastrointestinal bleeding(0.78%), chest tightness(10.94%), gastrointestinal reaction(45.31%), delirium(7.81%), skin eschar(98.44%), lymph node enlargement(76.56%), rash(48.44%), liver enlargement(17.94%), pleural effusion(10.94%),jaundice(20.31%), ascites(7.81%), etc. Most patients were associated with normal leukocytes(67.19%), eosinophil penia(83.59%), elevated CRP(96.09%), elevated ALT or AST(92.97%) and elevated myocardial enzymes(78.91%), and more organ damage was liver function injury(92.97%). Organ injury was positively correlated with age(OR =0.814, 95% CI:0.773-0.855) and fever time before admission(OR =1.346, 95% CI: 0.056 ～6.873), with statistical significance(waldχ~2=5.673,3.474,P<0.05). There was no significant correlation between organ injury and CRP(OR=2.541, 95%CI: 1.208-3.364)and thermal peak(OR=3.736, 95%CI: 2.862-4.153)(waldχ~2=35.370,6.425,P>0.05). Conclusion The clinical symptoms and signs of tsutsugamushi disease are quite diverse and often involve multiple systems in the human body. Among them, fever and eschar are the most diagnostic symptoms and signs. Eosinophilia can also be used as a diagnostic criterion for tsutsugamushi disease. The organ damage is typically liver function damage. Age before admission and fever time are related to organ function damage.更多还原