219例麻疹病例的临床特征

Clinical features of 219 cases of measles

摘要:

目的分析不同年龄段麻疹患者的临床特点,比较不同时期麻疹的流行特征，指导该病的诊治和防控。方法对2007年12月—2009年5月间收治的219例麻疹患者的临床资料按不同年龄组进行回顾性分析,并与5年前收治的150例麻疹患者资料进行比较。结果219例麻疹患者中以6个月～5岁儿童为主，占78.54%（172/219）。临床表现典型：96.35%（211例）的患者发热，其中体温＞39℃者占72.99%；所有患者均有皮疹，皮疹形态和出疹顺序符合典型麻疹表现，在病程第3、4天出疹者以6个月～5岁儿童最多，达82.56%；明确有麻疹黏膜斑者147例（67.12%）。肺炎（73.52%）是主要并发症；并发症的发生率以＜5岁儿童最高，其中肺炎的发生率占81.18%。有麻疹疫苗接种史者仅18例（8.22%）。结论麻疹好发人群为5岁以下儿童，临床表现典型，并发症发生率高，以肺炎为主。应加强计划免疫和针对成年人的强化免疫，以降低麻疹发病率。

Abstract:

ObjectiveTo guide the diagnosis, prevention and control of measles through analysis of clinical features of patients with measles in different age groups and by comparing epidemiologic features of measles during different periods.MethodsClinical data of 219 patients with measles who were hospitalized  between December,2007 and May,2009 were analyzed retrospectively , and data of 150 patients with measles in the  same  hospital 5 years ago were compared.ResultsAmong 219 patients with measles, the majority (78.54%,172/219) were between 6 months5 years old, the manifestations were typical: 96.35%(211 cases) had fever, 72.99% of whom had body temperature >39℃; all patients had skin rash, skin rash presenting  at the 3rd or 4th day of the disease course mainly occurred in patients who were between 6 months5 years old , which accounting for 82.56%; 147 patients(67.12%) had mucous patch. Pneumonia was the main complication, which accounting for 73.52%; complication rate was high in children who were <5 years  old, 81.18% of complications were pneumonia. The vaccination rate of measles vaccine was only 8.22%(18 cases).ConclusionMeasles mainly occurs in children under 5 years old , clinical manifestations are typical , and incidence of complications are  high. Planned immunization in children and intensifying immunization in adults should be strengthened to reduce the incidence of measles.