目的 对蜱传疾病患者流行病学资料、临床特征进行分析,以期为蜱传疾病诊治能力提升提供帮助.方法 收集北京地坛医院2013年1月至2023年6月收治的蜱传疾病患者资料,对流行病学和临床特征进行分析.结果 共纳入32例蜱传疾病患者临床资料,包括发热伴血小板减少综合征(severe fever with thrombocytopenia syndrome,SFTS)17例,莱姆病5例,立克次体病10例.发病时间集中在每年的5-10月.北京本土病例14例(43.8％),平谷区占比最高(4例,28.6％),外省输入性病例16例(50.0％),境外旅居患病人员2例(6.3％).病例年龄21～80岁,平均(50.16±14.61)岁.病例数最多的职业为农民(14例,43.8％).游走性红斑为莱姆病典型皮损特点,发热多见于SFTS及立克次体病患者,以中度发热为主.WBC及NEUT降低多见于SFTS.SFTS及立克次体病均有EOS降低.PLT减少为SFTS典型特征.立克次体病及SFTS患者表现出明显的肝脏损伤,ALT、AST明显升高.SFTS患者存在明显心肌损伤,CK、CK-MB均有升高.CRP升高主要见于立克次体病.PCT升高最常见于立克次体病,其次为SFTS.结论 北京地区蜱传疾病存在逐年上升趋势,多有延误诊断,需提升此类疾病的诊断能力,根据流行病学史和蜱传疾病临床特征进行早期识别,及早行病原学检测,从而提高早期诊断率,实现早诊早治.
Epidemiologic and clinical characterization of tick-borne diseases in an infectious disease hospital in Beijing over the past decade
Epidemiological data and clinical characteristics of patients with tick-borne diseases were analyzed to improve diagnosis and treatment outcomes.The data of 32 patients(epidemiology and clinical characteristics)treated for tick-borne diseases at Beijing Ditan Hospital from January 2013 to June 2023 were retrospectively reviewed.Of the 32 patients,17 were diagnosed with severe fever with thrombocytopenia syndrome(SFTS),5 with Lyme disease,and 10 with rick-ettsial disease.Disease was concentrated from May to Octo-ber each year.There were 14 local cases in Beijing(43.8％),with Pinggu District accounting for the highest proportion(4 cases,28.6％),16 imported cases from other provinces(50.0％),and 2 cases(6.3％)from people living abroad.The median time from disease onset to hospitalization was 8 days and the median length of hospitalization was 10 days.The mean age of patients with tick-borne diseases was 50.16±14.61(range,21-80)years.By occupation,farmers were at the greatest risk of tick-borne diseases(14 cases,43.8％).Erythema migrans(EM)was a typical skin lesion characteristic of Lyme disease,and fever was seen in all three groups,but mainly in patients with SFTS and rickettsial disease,who mainly presented with moderate fever.Decreased WBC and NEUT counts were most commonly seen in SFTS,whereas no WBC ab-normality was seen in patients with Lyme disease.Decreased EOS counts were seen in both SFTS and rickettsial disease,whereas no abnormality was seen in Lyme disease.Decreased PLT counts were typical of SFTS.Patients with rickettsial disease and SFTS showed significant liver damage with markedly elevated ALT and AST levels.Significant myocardial damage with ele-vated CK and CK-MB levels was seen in SFTS.Elevated CRP was mainly seen in rickettsial disease.Elevated PCT counts were mostly seen in rickettsial infections,followed by SFTS.The incidence of tick-borne diseases in Beijing continues to increase an-nually.Since diagnosis is often delayed,vigilant surveillance is key to improve diagnosis.Therefore,detailed epidemiological in-formation of each tick-borne disease based on clinical characteristics is needed to ensure early diagnosis and treatment.
tick-borne diseasessevere fever with thrombocytopenia syndromeLyme diseaserickettsiosisepidemiologyclinical characteristics
万方数据
维普
