165例麻疹患者临床特征比较

Clinical characteristics of 165 cases of measles

摘要:

目的对某院麻疹患者的流行病学及临床特征进行分析，比较成人和婴幼儿麻疹发病特点的差异。方法对该院2006年1月—2013年6月165例麻疹住院患者的临床资料进行回顾性分析，比较婴幼儿组和成人组的流行病学、临床表现及各种检查结果阳性率的差异。结果除12月份外，全年均有病例发生，患者主要集中在2—8月份（157例，95.15%）。成人组高热（68例，82.93%）、Koplik’s斑（78例，95.12%）、消化道症状（43例，52.44%）、眼部症状（61例，74.39%）的发生率均高于婴幼儿组［对应值分别为（39例，55.71%）、（47例，67.14%）、（23例，32.86%）、（41例，58.57%）］；Koplik’s斑的持续时间为（5.99±1.57）d，长于婴幼儿组的（3.12±1.41）d（均P<0.05）。成人组肝功能异常发生率（64例，78.05%）明显高于婴幼儿组（7例，10.00%）；而婴幼儿组并发支气管肺炎的发生率（29例，41.43%）明显高于成人组（12例，14.63%）（均P＜0.05）。 成人组32例患者入院第2天行CD4+T淋巴细胞绝对计数检查，其中30例(93.75%)出现CD4+T淋巴细胞绝对计数下降［（122.10±96.20）cells/μL］，26例治疗1周后复查CD4+T淋巴细胞绝对计数明显升高［（445.10±187.20）cells/μL］（P＜0.01）。结论成人麻疹更易出现高热、消化道症状、眼部症状和肝功能损伤，全身症状较重；婴幼儿麻疹更易并发支气管肺炎。

Abstract:

ObjectiveTo analyze the epidemiological and clinical characteristics of measles cases, and compare the differences between adult and infant measles. MethodsClinical data of 165 measles patients hospitalized between January 2006 and June 2013 were analyzed retrospectively, epidemiological and clinical characteristics between infant and adult measles were compared.ResultsExcept December, measles occurred all the year round, and mostly occurred between February and August (157 cases, 95.15%).The occurrence of high fever（n=68，82.93%）,Koplik’s spot（n=78，95.12%）,gastrointestinal symptoms（n=43， 52.44%）,eye symptoms（n=61， 74.39%）in adult group were higher than infant group(［n=39， 55.71%］,［n=47， 67.14%］,［n=23， 32.86%］,［n=41， 58.57%］,respectively), duration of Koplik’s spot in adult group was longer than infant group(［5.99±1.57］d vs［3.12±1.41］d)，(all P<0.05）, incidence of abnormal liver function in adult group was significantly higher than infant group(［n=64， 78.05%］vs［n=7， 10.00%］）,while incidence of bronchopneumonia in infant group was higher than adult group（［n=29， 41.43%］ vs ［n=12， 14.63%］）(both P＜0.05）.Of 32 adults who were performed detection of lymphocyte count on the second day of admission, 30(93.75%) were had decrease of absolute CD4+T lymphocyte count (［122.10±96.20］cells/μL)，repeated detection after oneweek treatment showed an elevated CD4+T lymphocyte count （［445.10±187.20］cells/μL） in 26 adults（P＜0.01）.ConclusionAdult measles is more likely to appear high fever, gastrointestinal symptoms, eye symptoms and liver injury, systemic symptoms are serious; while infant measles is more likely to appear bronchopneumonia.