安宁地区恙虫病73 例临床与实验室诊断分析

doi:10. 3969 / j. issn. 2096-2266. 2021. 08. 022

大理大学学报 ›› 2021, Vol. 6 ›› Issue (8): 93-96.DOI: 10. 3969 / j. issn. 2096-2266. 2021. 08. 022

安宁地区恙虫病73 例临床与实验室诊断分析

许文艳1，刘秋红2，马云麟3

（1. 云南昆钢医院检验科，昆明 650302；2. 云南昆钢医院感染性疾病科，昆明 650302；
3. 云南昆钢医院急诊科，昆明 650302）

收稿日期:2019-07-02 修回日期:2020-12-10 出版日期:2021-08-15 发布日期:2021-09-29
作者简介:许文艳，主任技师，主要从事血液细胞形态学及流式细胞检验研究。

Clinical and Laboratory Diagnosis Analysis of 73 cases of Tsutsugamushi Disease in Anning Area

Xu Wenyan1, Liu Qiuhong2, Ma Yunlin3

(1. Department of Medical Examination, Yunnan Kungang Hospital, Kunming 650302, China; 2. Department of Infectious Diseases,
Yunnan Kungang Hospital, Kunming 650302, China; 3 Department of Emergency, Yunnan Kungang Hospital, Kunming 650302,
China)

Received:2019-07-02 Revised:2020-12-10 Online:2021-08-15 Published:2021-09-29

摘要/Abstract

摘要： 目的：探讨安宁地区73 例恙虫病的临床特点与实验室特征，并筛选重症恙虫病的危险因素。方法：回顾性分析2015 年
1 月至2018 年12 月在云南昆钢医院住院治疗的73 例恙虫病患者的临床特点，实验室特征及治疗情况。同时依据重症诊断标准将
患者分为重症恙虫病组（18 例）和非重症恙虫病组（55 例），比较分析两组患者的临床特征及实验室检查结果，探讨重症恙虫
病发生相关的危险因素。结果：73 例恙虫病患者发病以夏秋型为主，发病时间集中在每年的7~10 月。临床特征为所有患者均发热，
87.7％的患者可发现焦痂，其他不典型的临床表现有：恶心、腹痛和腹泻等。与恙虫病发病相关的阳性实验室指标有丙氨酸氨基
转移酶（ALT）、天冬氨酸氨基转移酶（AST）、乳酸脱氢酶（LDH）、降钙素原（PCT）和C 反应蛋白（CRP）增高，嗜酸性
粒细胞比例（Eos％）减少，检出异型淋巴细胞。血小板（PLT）计数减少、CRP、PCT、AST、LDH 升高在重症恙虫病组和非重
症恙虫病组间差异有统计学意义（P ＜ 0.01）。结论：恙虫病除高热外，临床表现多种多样，并且存在多种实验室检查结果异常，
临床医师在恙虫病高发季节需认真询问病史及综合分析各种实验室数据，查找身体隐蔽部位的焦痂，避免恙虫病的漏诊和误诊；
重症恙虫病患者易发生PLT 计数减少和CRP、PCT、AST、LDH的增高。应早期发现并给予积极治疗，以降低重症恙虫病的病死率。

关键词: 恙虫病, 焦痂, 淋巴细胞亚群, 异型淋巴细胞

Abstract: Objective: To explore the clinical characteristics and laboratory characteristics of 73 cases of tsutsugamushi disease in
Anning area, as well as the risk factors of severe tsutsugamushi disease. Methods: The clinical characteristics, laboratory characteristics,
and treatment of 73 cases of tsutsugamushi disease hospitalized in Yunnan Kungang Hospital from January 2015 to December 2018
were retrospectively analyzed. According to the criteria of severe diagnosis, the patients were divided into 18 cases in the severe
group and 55 cases in the non-severe group. The clinical characteristics and laboratory results of the two groups were compared to
explore the risk factors associated with the occurrence of severe tsutsugamushi disease. Results: The incidence of 73 cases of tsutsugamushi
disease was mainly in summer and autumn, and the onset time was concentrated in July to October every year. Clinical features: all
patients had fever, and 87.7% of patients has eschar. Other atypical clinical manifestations: sick, abdominal pain, and diarrhea. Positive
laboratory indicators associated with the incidence of tsutsugamushi disease have elevated ALT, AST, LDH, PCT and CRP, decreased
eosinophils, and abnormal lymphocytes. PLT reduction, CRP, PCT, AST, and LDH elevation were statistically significant between the
severe tsutsugamushi disease group and the non-severe tsutsugamushi disease group (P<0.01). Conclusion: In addition to high fever,
tsutsugamushi disease has a variety of clinical manifestations, and there are a variety of laboratory abnormalities. Clinicians need to
carefully ask about the medical history, do comprehensive analyses of various laboratory data during the high seasons of tsutsugamushi
disease and find the eschar of the hidden parts of the body to avoid missed diagnosis and misdiagnosis of tsutsugamushi disease; patients
with severe tsutsugamushi disease are prone to PLT reduction and increased CRP, PCT, AST and LDH. Active early treatment should
be carried out to reduce the mortality of severe tsutsugamushi disease.

Key words: tsutsugamushi disease, eschar, lymphocyte subsets, abnormal lymphocytes

中图分类号:

R513.2

许文艳, 刘秋红, 马云麟. 安宁地区恙虫病73 例临床与实验室诊断分析[J]. 大理大学学报, 2021, 6(8): 93-96.

Xu Wenyan, Liu Qiuhong, Ma Yunlin. Clinical and Laboratory Diagnosis Analysis of 73 cases of Tsutsugamushi Disease in Anning Area[J]. Journal of Dali University, 2021, 6(8): 93-96.

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安宁地区恙虫病73 例临床与实验室诊断分析

Clinical and Laboratory Diagnosis Analysis of 73 cases of Tsutsugamushi Disease in Anning Area

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