摘要
目的探讨广东地区恙虫病患者胸部影像学改变与临床特征之间的关系。方法将1999年至2010年来自暨南大学附属第一医院、广州市第八人民医院、韶关市粤北第二人民医院住院的148例恙虫病患者分为胸部x线片异常组和胸部x线片正常组，采用t检验、7。检验或Fisher确切概率法进行统计学分析，比较两组患者的临床特点及其预后。结果148例恙虫病患者中，胸部影像学异常66例，占44．6％。胸部X线片异常组的咳嗽、严重血小板减少、低白蛋白血症、休克、急性呼吸衰竭、黄疸及急性肾功能衰竭的发生率明显高于胸部X线片正常组（X^2=18．193、6．872、17．138、5．608、4．318、7．982和7．932，均P〈0．05）。胸部X线片正常组住院时间为（9．9±5．0）d，少于胸部X线片异常组的（11．7±7．1）d，但差异无统计学意义（t=1．717，P=0．088）。胸部X线片异常组病死率为6．1％，高于胸部X线片正常组的0（Fisher确切概率法，P=0．038）。结论恙虫病患者临床表现复杂多样，伴发胸部X线片异常很可能提示严重的恙虫病，应仔细分析病情，及时进行正确诊治。
Objective To investigate the relationship between chest radiographic changes and clinical manifestations in patients with scrub typhus in Guangdong area. Methods A total of 148 cases of scrub typhus admitted to First Affiliated Hospital of Jirnan University, Guangzhou Eighth Peoplers Hospital and the Second People＇s Hospital of Yuebei between 1999 and 2010 was retrospectively reviewed. The patients were divided into two groups based on the findings of the chest X-rays （with or without radiographic abnormalities）. Furthermore, the clinical characteristics and prognosis in two groups were compared. The statistical analysis was done using t test, ehi-square test or Fisherrs exact test. Results Chest X-rays showed abnormalities in 66 （44.6%） cases, and the chest X-ray features were diverse. The incidences of cough, severe thrombocytopenia, hypoalbuminemia, shock, acute respiratory failure, jaundice and acute renal failure were all significantly increased in group of patients with chest X-rays abnormalities compared with the other group of patients without chest X-rays abnormalities （X^2 = 18. 193,6. 872,17. 138,5. 608,4. 318,7. 982 and 7. 932, respectively; all P〈0.05）. The hospitalization day was longer in patients with chest X-rays abnormalities compared with the patients without chest X-rays abnormalities, but there was no statistical difference [（11.7±7.1） dvs （9.9 ± 5.0） d, t = 1.717 ; P = 0. 088） ], while the mortality was higher （6.1 %vs 0 ; Fisher＇ s exact test, P = 0. 038）. Conclusions The clinical manifestations of the patients with scrub typhus are diverse, and the presence of abnormal chest X-rays is shown to be associated with the disease severity. Physicians should have the awareness of scrub typhus to make the diagnosis and treatment properly.
出处
《中华传染病杂志》
CAS
CSCD
北大核心
2012年第6期359-362,共4页
Chinese Journal of Infectious Diseases
关键词
恙虫病
放射摄影术
胸部
预后
Scrub typhus
Radiography, thoracic
Prognosis
