發(fā)布時間：2018-03-20 13:40

  本文選題：發(fā)熱　切入點(diǎn)：血小板減少　出處：《中國全科醫(yī)學(xué)》2017年06期 　論文類型：期刊論文

【摘要】：背景發(fā)熱伴血小板減少綜合征(SFTS)人人間傳播的患者報(bào)道越來越多,但缺乏詳盡的臨床特征總結(jié)。目的總結(jié)我國SFTS人人間傳播患者的危險因素、臨床表現(xiàn)、實(shí)驗(yàn)室檢查特點(diǎn),提高臨床醫(yī)生對SFTS人人間傳播的認(rèn)識,減少SFTS人人間傳播及誤診誤治。方法檢索2007年1月—2016年3月Medline、Pub Med、Embase、Google Scholar Databases、相關(guān)期刊論文、萬方全文數(shù)據(jù)庫、維普全文數(shù)據(jù)庫,采用高級檢索,檢索項(xiàng)均為全部字段,以"發(fā)熱伴血小板減少綜合征""人人間傳播""severe fever with thrombocytopenia syndrome"和"person-toperson transmission"為檢索詞,下載檢索到的全部文獻(xiàn),仔細(xì)閱讀所有文獻(xiàn)的全文,剔除重復(fù)收錄、重復(fù)發(fā)表、同一單位或個人的重復(fù)報(bào)道的文獻(xiàn)�；仡櫺苑治龇霞{入標(biāo)準(zhǔn)的56例SFTS人人間傳播患者的臨床資料。結(jié)果檢索到符合標(biāo)準(zhǔn)的文獻(xiàn)7篇,共56例患者,其中原發(fā)患者8例,繼發(fā)患者48例。繼發(fā)患者潛伏期為6~15 d;45例有接觸原發(fā)患者血液或血性分泌物的危險因素,2例可疑經(jīng)空氣傳播,1例經(jīng)蜱蟲傳播;主要臨床表現(xiàn)為發(fā)熱、寒戰(zhàn)、腹瀉,其次為惡心、嘔吐、出血、腹痛、咳嗽、皮疹、結(jié)膜充血、頭痛、肌痛等�；颊呔霈F(xiàn)白細(xì)胞計(jì)數(shù)及血小板計(jì)數(shù)下降,血清丙氨酸氨基轉(zhuǎn)移酶及血清天冬氨酸氨基轉(zhuǎn)移酶升高;其余實(shí)驗(yàn)室檢查結(jié)果異常包括乳酸脫氫酶升高、活化部分凝血活酶時間延長、肌酐升高、肌酸激酶升高、出現(xiàn)蛋白尿及血尿。結(jié)論 SFTS人人間傳播得到證實(shí),主要通過接觸患者血液或血性分泌物傳播,有可疑空氣傳播。大部分為顯性感染,少部分為隱性感染。人人間傳播的潛伏期比蜱蟲叮咬傳播的潛伏期短,臨床癥狀輕,病死率低,早期診治預(yù)后良好。
[Abstract]:Background there are more and more reports of patients with fever associated with thrombocytopenia syndrome transmitted from human to human, but lack of detailed summary of clinical features. Objective to summarize the risk factors, clinical manifestations and laboratory findings of patients with human transmission of SFTS in China. Methods to improve the clinical doctors' understanding of human SFTS transmission, reduce SFTS human transmission and misdiagnosis and mistreatment. Methods the contents of Medline Pub Medbase Scholar Database, China Journal Full-text Database, Wanfang Full-text Database and Weip Full-text Database were searched from January 2007 to March 2016. Using advanced retrieval, all the search items were all fields, "severe fever with thrombocytopenia syndrome" and "person-toperson transmission" and "severe fever with thrombocytopenia syndrome" and "person-toperson transmission" were used as the key words, and the full text of all the literatures was carefully read. The clinical data of 56 SFTS human-to-human transmission patients who met the inclusion criteria were retrospectively analyzed. Among them, 8 cases were primary patients, 48 cases were secondary patients. The latent period of secondary patients was 615 days, 45 cases had exposure to blood or blood secretion of primary patients, 2 cases were suspected to be transmitted by air, 1 case was transmitted by ticks, the main clinical manifestations were fever and shivering. Diarrhea, followed by nausea, vomiting, bleeding, abdominal pain, cough, rash, conjunctival congestion, headache, myalgia, etc. The levels of serum alanine aminotransferase and aspartate aminotransferase were increased. The other laboratory findings included the increase of lactate dehydrogenase, the prolongation of activated partial thromboplastin time, the increase of creatinine, and the increase of creatine kinase. Conclusion the human transmission of SFTS is confirmed mainly through contact with blood or blood secretions of the patient, and there is suspicious air transmission. Most of them are dominant infections. The latent period of human transmission was shorter than that of tick bite transmission, the clinical symptoms were mild, the mortality rate was low, and the early diagnosis and treatment had a good prognosis.
【作者單位】： 中國醫(yī)科大學(xué)附屬第一醫(yī)院傳染科;
【基金】：遼寧省自然科學(xué)基金資助項(xiàng)目(2014021063) 沈陽市科學(xué)技術(shù)項(xiàng)目計(jì)劃(F13-220-9-23)
【分類號】：R511
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本文編號：1639319