中国首例输入性基孔肯雅热临床分析

摘要

Objective To investigate the epidemiological, clinical and pathogenic characteristics and prognosis of the first imported case of Chikungunya fever in China in 2008. Methods Epidemiological and clinical data of this mate adult patient were analyzed retrospectively. Chikungunya virus (CHIKV)-IgM was detected using enzyme linked immunosorbent assay (ELISA) and colloidal gold immunoassay. CHIKV-RNA was detected using real-time fluorescent polymerase chain reaction (RT-PCR). Results This patient had onset of fever on March 2 in 2008 and lasted for 5 days. In addition, he felt joint and muscle pains, headache and found generalized engorged maculopapule. The laboratory tests showed leukopenia and thrombocytopenia. CHIKV-IgM was detected positive at day 9 after the onset and CHIKV-RNA was all positive at day 3, 5, 7, 9 after the onset. A 575 bp fragment of RT-PCR product was sequenced and detected the nucleotide homology was 99% compared with CHIKV sequences in GenBank. The patient recovered with symptomatic supportive treatment.Conclusion This imported case of Chikungunya virus infection is reported for the first time in China.It shows similar clinical manifestations with dengue fever.%目的 了解2008年我国首例输入性基孔肯雅热病例的流行病学、临床、病原学特点及预后转归.方法 对1例成年男性患者流行病学及临床资料进行回顾性分析,并采用ELISA和胶体合法检测患者血清基孔肯雅病毒IgM(CHIKV-IgM)抗体,实时荧光PCR法检测基孔肯雅病毒核酸(CHIKV RNA).结果 该患者临床表现为发热起病,有头痛、全身肌肉及关节酸痛,全身充血性斑丘疹,WBC及PLT减少.发病第9天CHIKV-IgM阳性;第3、5,7、9天CHIKV RNA阳性;RT-PCR扩增产物为575个核苷酸碱基片段,经序列测序结果与基孔肯雅病毒核酸序列同源性高达99%.患者经对症支持等治疗痊愈出院.结论 该患者为我国首例输入性基孔肯雅热确诊病例,本病临床表现与登革热相似.