摘要
目的 研究长沙地区猴痘患者临床及流行病学特征,结合实验室、超声结果,为疫情防控提供依据.方法 分析2023年6月29日至12月15日在长沙市第一医院住院治疗的猴痘患者的流行病学特征、临床表现及实验室、超声结果,比较合并人免疫缺陷病毒(human immunodeficiency virus,HIV)感染的患者与未感染HIV患者实验室检查结果的差异.结果 44例猴痘患者中位年龄为33岁,均为男性,均有男男性行为史,81.82％患者未婚,38.64％患者无业,40.91％患者感染梅毒螺旋体,61.36％患者感染HIV,其中88.89％患者接受抗反转录病毒治疗(Antiretroviral therapy,ART).中位潜伏期为5 d,发病到住院中位时间为6.88 d,中位住院时间为10.51 d.患者均有皮疹,主要分布在生殖器、四肢、颜面部、躯干、肛周.多数患者有发热,淋巴结肿大以腹股沟多见.与合并HIV感染的猴痘患者相比,未感染HIV的猴痘患者中性粒细胞较低,红细胞、白蛋白、谷草转氨酶、总胆红素、肌酸激酶同工酶较高.结论 长沙地区猴痘患者以中青年男性为主,通过男男性行为传播,皮疹、发热、淋巴结肿大为主要表现.
Abstract
This study investigated the clinical and epidemiological characteristics of patients with monkeypox in the Chang-sha City,and analyzed the results of laboratory and ultrasound examinations,to provide a basis for monkeypox epidemic pre-vention and control.Epidemiological characteristics,clinical manifestations,laboratory tests,and ultrasound examinations for 44 patients with monkeypox hospitalized at the First Hospital of Changsha between June 29,2023,and December 15,2023,were analyzed.Differences in laboratory results were compared between patients with monkeypox with versus without HIV in-fection.The median age of the 44 patients with monkeypox was 33 years.All patients were men who had sex with men within 21 days before the diagnosis of monkeypox.A total of 81.82％patients were unmarried,and 38.64％were unemployed.Moreo-ver,40.91％of patients were infected with Treponema pallidum,and 61.36％patients were infected with HIV,of whom 88.89％received ART.The median incubation period was 5 days.The median time from onset to hospitalization was 6.88 days.The median hospitalization time was 10.51 days.All patients presented with skin rash,distributed primarily in the repro-ductive organs,limbs,facial features,trunk,and perianal area.Most patients had fever.Lymph node enlargement oc-curred mainly in the groin.Compared with patients who were co-infected with HIV,the other patients had lower levels of neutrophils,and higher levels of red blood cells,albumin,aspartate aminotransferase,total bilirubin,and creatine kinase isoenzymes.Most patients with monkeypox in the Changsha City were middle-aged or young men who had sex with men.The main manifestations included rash,fever,and enlarged lymph nodes.
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