摘要
目的分析广州市猴痘病例的临床与实验室特征。方法收集2023年6月8日至6月21日广州医科大学附属市八医院收治的猴痘患者的一般情况、症状、体征、实验室检查结果,对比分析合并人类免疫缺陷病毒(HIV)感染者与HIV阴性者的临床特征。统计学分析采用独立样本t检验、曼-惠特尼U检验和Fisher确切概率法。结果19例猴痘患者均未曾接种天花疫苗,均为男同性恋者,发病前21 d内均有男男同性性行为史,年龄为(33.2±6.4)岁,合并HIV感染、梅毒者各8例。19例均出现皮疹,15例为首发症状,4例在病程中出现。17例患者有淋巴结肿大,15例淋巴结压痛,15例咽部充血,13例扁桃体肿大,11例发热,10例瘙痒。分别有13例患者的CD8^(+)T淋巴细胞计数、降钙素原、白细胞介素10(IL-10)升高,12例血清淀粉样蛋白A升高,7例血淋巴细胞计数升高。8例合并HIV感染,其中1例急性感染,7例慢性感染,这7例均已接受规律抗病毒治疗,起病前CD4^(+)T淋巴细胞计数为657(400,757)/μL。HIV阳性者与HIV阴性者的年龄(t=1.55)、并发症发生率(Fisher确切概率法)、皮疹数量(Z=-0.21)、淋巴结肿大发生率(Fisher确切概率法)、发热发生率(Fisher确切概率法)、发热天数(Z=-0.48)、血淋巴细胞计数(t=-1.55)、CD4^(+)T淋巴细胞计数(Z=-0.17)、CD8^(+)T淋巴细胞计数(Z=-1.49)的差异均无统计学意义(均P>0.05)。皮疹数量为19(6,26)个,主要分布在会阴及附近区域(17例),入院时常见皮疹形态为丘疹(15例)、焦痂(15例)、脓疱(12例)。所有患者经外用药物和对症治疗后痊愈。结论广州市猴痘患者以青中年男男同性性行为者为主,主要表现为皮疹、淋巴结肿大伴压痛、咽部充血、扁桃体肿大及发热,常见的实验室检查异常为炎症指标升高,免疫功能正常的HIV感染合并猴痘患者的临床特点与HIV阴性猴痘患者相似。
Objective To analyze the clinical and laboratory characteristics of mpox patients in Guangzhou City.Methods The general conditions,symptoms and signs,and laboratory test results of mpox patients admitted to Guangzhou Eighth People′s Hospital,Guangzhou Medical University from June 8 to June 21,2023 were collected.The clinical characteristics of human immunodeficiency virus(HIV)-infected patients and HIV-negative patients were compared.Independent sample t test,Mann-Whitney U test and Fisher exact probability method were used for statistical analysis.Results Nineteen mpox patients were included in this study,none of them had been vaccinated with smallpox vaccine.All of them were identifed as gay men with an age of(33.2±6.4)years.And all of them had sex with men within 21 days of onset.There were eight cases with HIV infection and syphilis,respectively.All of these 19 patients had skin lesions which were the first symptom of 15 patients,and appeared during the course of the disease of four patients.Other common symptoms and signs were lymph node enlargement(17 cases),lymph node tenderness(15 cases),pharyngeal congestion(15 cases),tonsil enlargement(13 cases),fever(11 cases)and pruritus(10 cases).There were 13 cases with elevated CD8^(+)T lymphocytes,interleukin-10 level and procalcitonin level,respectively,12 cases with elevated serum amyloid A level,and seven cases with elevated blood lymphocyte count.Eight patients were infected with HIV,including one acute infection and seven chronic infections(all of them had received regular antiviral therapy and had a CD4^(+)T lymphocyte count of 657(400,757)/μL before onset).There were no significant differences in age(t=1.55),incidence of complications(Fisher exact probability method),number of skin lesions(Z=-0.21),incidence of lymph node enlargement(Fisher exact probability method),incidence of fever(Fisher exact probability method),duration of fever(Z=-0.48),lymphocyte count(t=-1.55),CD4^(+)T lymphocyte count(Z=-0.17)and CD8^(+)T lymphocyte count(Z=-1.49)between the H
作者
杨慧勤
郑海鹏
陈旭丹
谭颖
张复春
王建
李凌华
Yang Huiqin;Zheng Haipeng;Chen Xudan;Tan Ying;Zhang Fuchun;Wang Jian;Li Linghua(Infectious Disease Center,Guangzhou Eighth People′s Hospital,Guangzhou Medical University,Guangzhou 510440,China)
出处
《中华传染病杂志》
CAS
CSCD
2023年第11期695-700,共6页
Chinese Journal of Infectious Diseases
基金
2022年广州市科技局市校(院)联合资助项目(202201020285、202201020276)2021~2023年广州市医学重点学科(病毒性传染病)。
关键词
猴痘
疹
人类免疫缺陷病毒感染
临床特征
炎性指标
Monkeypox
Exanthema
HIV infection
Clinical Characteristics
Inflammatory markers
