黑热病47例流行病学及临床特征分析

摘要

To discuss the epidemiology and clinical features of kala azar to provide evidence for reducing misdiagnosis and mistreatment Methods We used bone marrow aspiration or rk39 test paper strip to test the patients. Results A total 47 patients had the history of living in the epidemic areas. The disease attacked monthly. The most frequent onset time was from Feb to Jun (68. 09% ). There were more male patients than female patients. The age of onset was manly less than 16. The ones under 16 years old accounted for 80. 85% of the patients. About 95. 75% patients took 6 months from onset to final diagnosis. The course of disease was related to the time of misdiagnosis. The main clinical manifestations were the long-term irregular fever (100. 00% ) , progressive a-nemia (100% ), splenomegaly (95. 74% ) pancytopenia {89. 63% ) , and the increase of plasma protein (57.45% ). The incidence of masculine of the rk39 dipstick check was 100% , which was significantly higher than that of bone marrow aspiration smear (55. 56% ). Conclusions It is of critical importance to understand the epidemiology and clinical features of kala azar and carry out timely check of pathogen and blood serum.%目的 探讨黑热病的流行病学与临床特征,为减少误诊误治提供依据.方法 对就诊患者采用骨髓穿刺或rk39试纸条检测,阳性者收集整理流行病学、发病情况、临床表现、辅助检查和病历记录等资料,给予锑剂药物治疗.结果47例患者均有流行区居住史；各月均有发病,以2～6月居多,占全年发病的68.09％；男性多于女性,年龄以16岁及以下发病较多,占发病数的80.85％；发病至确诊时间6个月内的占95.75％,病程长短与误诊时间有关.主要临床表现为长期不规则发热( 100.00％),进行性贫血和脾肿大(100.00％、95.74％)；以白细胞为主的全血细胞减少及血浆球蛋白增高(89.63％和57.45％).47例rk39试纸条检查阳性为100％,明显高于骨髓穿刺涂片55.56％.结论 了解黑热病流行病学与临床特征,及时给予病原学检查或血清学检测是避免漏诊误诊的关键.