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论著·临床研究 | 更新时间:2025-11-05
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50例基孔肯雅热患者的流行病学及临床特征分析
Epidemiological and clinical characteristics of 50 patients with chikungunya fever: an analytic study

广西医学 页码:1450-1453

作者机构:梁运光,本科,副主任医师,研究方向为重症传染性疾病。

基金信息:广西科技计划重点研发项目(桂科AB25069008);广西壮族自治区卫生健康委员会自筹经费科研课题(Z20210657)

DOI:10.11675/j.issn.0253⁃4304.2025.10.10

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目的 分析基孔肯雅热患者的流行病学及临床特征。方法 回顾性分析50例基孔肯雅热患者的流行病学史和临床资料,分析其流行病学特征、临床表现、实验室指标及临床转归。 结果 (1)50例基孔肯雅热患者均为轻症病例,男性25例、女性25例,年龄6~89(44.3±2.6)岁,17例患者合并基础疾病,3例患者有明确的疫区(佛山市乐从镇)接触史,4例患者的居住场所存在基孔肯雅热确诊病例,43例无疫区接触史。共有2个家庭聚集性发病,涉及5例患者。患者从出现症状到就诊时间为2~168 h,中位时间为52 h。(2)临床症状主要以发热、关节痛、皮疹为主,其中25例患者出现发热、关节痛、皮疹三联征,16例患者出现上述任意两种症状;44例患者出现发热,主要为低中度发热;39例患者出现关节痛,其中33例为双侧对称性关节痛,以腕关节受累最为常见;35例患者出现皮疹,以全身散在红色斑丘疹多见。(3)8例患者白细胞数量减少,15例患者C反应蛋白水平升高,8例患者肝功能异常,4例患者血肌酐水平升高,4例患者心肌酶水平升高,9例患者尿酸水平升高;37例患者心电图异常,以ST段改变为主。(4)患者住院天数为2~8 d,平均5.2 d,45例患者治愈或好转且达到解除隔离标准出院;11例患者出院时遗留少量陈旧性皮疹,7例患者出院时仍有部分关节隐痛。结论 基孔肯雅热病毒通过蚊媒叮咬传播,临床表现主要为发热、关节痛、皮疹,多数病例的临床症状较典型,病程短,病情较轻,并发症较少且程度较轻,预后较好。

Objective To analyze the epidemiological and clinical characteristics of patients with chikungunya fever. Methods The epidemiological history and clinical data of 50 patients with chikungunya fever were retrospectively analyzed, and their epidemiological characteristics, clinical manifestations, laboratory indicators, and clinical outcome were analyzed. Results (1) All 50 chikungunya fever cases were mild, comprising 25 males and 25 females, aged 6-89 (44.3±2.6) years. Among them, 17 patients had underlying diseases, 3 had a clear history of exposure in epidemic areas (Lecong Town, Foshan), and 4 lived in residences with confirmed chikungunya fever cases, while 43 had no history of exposure to epidemic areas. There were two family clusters involving 5 patients. The time from symptom onset to medical consultation ranged from 2 to 168 hours, with a median time of 52 hours. (2) The clinical manifestations were primarily fever, arthralgia, and rash. Among them, 25 patients presented with the classic triad of fever, arthralgia, and rash, whereas 16 patients exhibited any two of these aforementioned symptoms. Fever occurred in 44 patients, mainly low to moderate grade. Arthralgia was reported in 39 patients, with 33 cases presenting as bilateral symmetric joint pain, most commonly involving the wrists. A rash was observed in 35 patients, mostly characterized as disseminated erythematous maculopapular rash throughout the body. (3) Eight patients presented with leukopenia, 15 exhibited elevated C⁃reactive protein level, 8 had abnormal liver function, 4 indicated elevated serum creatinine level, 4 had increased myocardial enzymes level, and 9 demonstrated elevated uric acid level. Abnormal electrocardiogram findings were observed in 37 patients, predominantly showing ST⁃segment changes. (4) The length of hospital stay ranged from 2 to 8 days, with a mean of 5.2 days. Forty⁃five patients were discharged after being cured or improved and meeting the deisolation criteria. At discharge, 11 patients retained minor residual old rashes, and 7 still experienced mild arthralgia. Conclusion Chikungunya virus is transmitted through mosquito⁃borne bites, mainly manifested by fever, arthralgia and rash. The clinical symptoms of most cases are typical, with a short course of disease, mild condition, few complications and mild severity, and a good prognosis.

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