2014年广州大学城登革热的临床特征分析

摘要

Objective To analyze the clinical characteristics of dengue fever (DF) in Guangzhou Higher Education Mega Center (HEMC) in the year of 2014. Methods A retrospective analysis was carried out in the clinical data of 487 cases of DF patients. Results The incidence of DF accounted for 27.18% ( 527/1939) of the total emergeney fever cases. In 487 DF cases with detailed data, 261 were male, and 226 were female; 312 were young aged, 88 were middle aged, and 87 were old aged. For the systemic symptoms, fever accounted for 87.5%, headache 48.3%, and muscular soreness 47.6%. Cough ( 16.6%) , pharynx pain ( 16.8%) and running nose ( 10.9%) were common in respiratory symptoms; poor appetite ( 14.4%) and nausea ( 10.3%) were common in gastrointestinal symptoms. The abnormal laboratory parameters were mainly shown as WBC count ( 48.25%) and PLT count ( 41.68%) , following by creatine kinase ( CK, 39.49%) , aspartate aminotransferase ( AST, 34.12%) , and lactate dehydrogenase ( LDH, 31.96%) . Less cases had abnormal renal function. The distribution of Chinese medical syndrome types was shown as damp-heat blockage (65.7%), syndrome involving Weifen and Qifen simultaneously (23.6%), and Qi-yin deficiency (10.7%). Conclusion In the year of 2014, DF in Guangzhou HEMC occurred mainly among the youth people, the incidence of male DF was similar to that of the female DF, and DF cases usually have the primary symptoms of fever, aversion to cold, headache and muscular soreness. Bleeding is seldom seen in the DF patients, a few cases are complicated with the damage in the blood, liver and myocardium, and most of them have good prognosis.%【目的】分析2014年广州大学城登革热的临床特征。【方法】对487例登革热患者临床资料进行回顾性分析。【结果】确诊登革热患者为527例，占急诊发热总人数的27．18％（527／1939）。纳入本研究的完整病例资料为487例，其中男261例，女226例；青年312例，中年88例，老年87例。全身症状中以发热（占87．5％）最多见，头痛（占48．3％）、肌肉酸痛（占47．6％）次之；呼吸道症状中以咳嗽（占16．6％）、咽痛（占16．8％）多见，流涕（占10．9％）次之；胃肠道症状中以纳差（占14．4％）多见，恶心（占10．3％）次之。实验室指标异常以白细胞计数（ WBC）（占48．25％）和血小板（ PLT）（41．68％）多见，其次是肌酸激酶（CK）（占39．49％）、乳酸脱氢酶（LDH）（占31．96％）、天门冬氨酸转氨酶（AST）（占34．12％），肾功能异常较少见。中医证型分布依次为：湿热阻遏（65．7％）＞卫气同病（23．6％）＞气阴不足（10．7％）。【结论】2014年广州大学城登革热患者以青年多见，男女发病比例接近；多以发热、恶寒、头痛、肌肉酸痛为首要症状，出血较少见；少数并发血液、肝脏、心肌损害，预后多良好。