摘要
目的探讨黑热病患者免疫学异常的临床特点。方法回顾性分析2006~2014年确诊的22例黑热病住院患者的临床表现、实验室检查特点、治疗及预后。结果 22例患者中17例骨髓穿刺查见杜氏利什曼原虫,1例骨髓穿刺未见,但骨髓活检查见杜氏利什曼原虫,3例骨髓穿刺及活检均未见杜氏利什曼原虫,但查抗利什曼原虫抗体阳性,治疗有效而诊断。22例患者血常规均有白细胞及红细胞减少,18例患者同时有血小板减少。16例患者检查凝血功能,其中9例PT延长,12例APTT延长。12例患者检查CRP均增高。多数患者ANA等免疫学指标异常。所有患者经过葡萄糖酸锑钠的治疗均治愈。结论黑热病的免疫学异常表现常见,可出现多种特异性很高的自身抗体,同时亦可出现血液系统损害及凝血功能异常,临床上易误诊为结缔组织病,需加强认识,以减少误诊,通过积极治疗预后良好。
Objective We analyzed the clinical features of immunological abnormalities of kala-azar patients.Methods A retrospective analysis of clinical features,laboratory examinations,treatment and prognosis was performed on kala-azar 22 who were treated at our department from 2006 to 2014.Results Of the 22 patients,leishmania donovani was found in 17 patients during bone marrow puncture.The pathogen was not found during bone marrow puncture but revealed during bone marrow biopsy in one case. The pathogen was not found during bone marrow puncture or biopsy in 3 patients but the there was positive for anti-Leishmania antibodies.Their diagnosis was confirmed by effective therapy.Moreover,the 22 patients all had reduced blood leukocytes and erythrocytes,and 18 patients also had thrombocytopenia.In 16 patients having examination of coagulation function,PT in 9 patients and APTT in 12 patients were prolonged.CRP levels in 12 patients were increased.In most of the patients,ANA and other immunological abnormalities were determined.All patients were cured with sodium stibogluconate treatment.Conclusion Abnormal immunological indexes in kala-azar are common.There may be a variety of specific autoantibodies.At the same time,blood system damage and coagulation dysfunction may also occur.These may be clinically misdiagnosed as connective tissue disease. Therefore,it needs to strengthen the awareness in order to reduce misdiagnosis.Through active treatment,prognosis of the disease is good.
出处
《实用医院临床杂志》
2016年第3期54-56,共3页
Practical Journal of Clinical Medicine
关键词
黑热病
免疫学
临床
Kala-azar
Immunology
Clinic
