422例发热伴血小板减少综合征临床特点分析

摘要

Objective To investigate the epidemiological and clinical features in patients with severe fever with thrombocytope-nia syndrome (SFTS). Methods A retrospective study was conducted in 422 SFTS patients with detailed medical records including epi-demiology, clinical manifestations, laboratory findings, treatment procedures and prognosis, who were treated in a certain hospital in Xinyang City, Henan Province, from Apr. 2007 to May 2011. Results Adult farmers accounted for a large proportion, and the onset of the disease mainly occurred from May to July each year. A history of tick bites was found in 21.80%of the patients. The major clinical symptoms were fever, fatigue, muscle pain, loss of appetite, general malaise, diarrhea, nausea, vomiting and headache. The major clini-cal sign was enlargement and tenderness of superficial lymph node. Laboratory findings were characterized by decrease in WBC and PLT, and elevated levels of ALT, AST, CK and LDH. Sixty-eight patients died, with the fatality rate of 16 . 11%. Conclusions The clinical manifestations of the patients with SFTS may be diverse, usually accompanied by obvious abnormality of biochemical markers. Supportive treatment should be initiated in clinical practice.%目的：探讨发热伴血小板减少综合征的流行病学及临床特征。方法对河南省信阳市某医院2007年4月—2011年5月收治的422例发热伴血小板减少综合征病例资料进行回顾性分析。结果患者以成年农民为主，多在5—7月发病，21.80%患者有蜱叮咬史。症状主要表现为发热、乏力、肌肉酸痛、纳差、全身不适、腹泻、恶心、呕吐和头痛。体征主要表现为腹股沟淋巴结肿大伴触痛。实验室指标异常主要为WBC、PLT降低，ALT、AST、CK和LDH升高。68例死亡，病死率为16.11%。结论发热伴血小板减少综合征临床表现多样，伴有实验室检测指标明显异常。在诊疗过程中，宜采取有效的对症支持治疗。