| ObjectiveTo study the variation of clinical features of dengue cases in 2013 and 2015 in Xishuangbanna,and providing evidences to make out treatment programs for the dengue patients and control dengue transmission for the healthy department in China.Methods1009 dengue patients' clinical data were analyzed on their symptoms and biochemical indicators in The People's Hospital and The Infectious Diseases' Hospital of Xishuangbanna Prefacture in 2013 and 2015 by retrospective analysis,and using the SPSS statistical software(17.0)for their statistical analysis,as well as using c2test to compare with their different rates.ResultsIn 2013,The outbreak of dengue fever in Xishuangbanna was caused by dengue virus-3,and it again occured by dengue virus-2 in 2015.By analyzing these 1009 dengue cases,it was found that the population was susceptible to the dengue virus,in those adults was most from 21 years old to 60 ones(74.52%,752/1009).For the clinical symptoms of 2013 and 2015,dengue patients in Xishuangbanna were main at high fever,fatigue,muscle aches and loss of appetite,and patients' temperature of Dengue virus-3 was generally higher than those of dengue virus-2,the former in the nausea and appetite loss were lower than the latter,but the former in the rate of others symptoms such as headache,bone pain,abdominal pain,diarrhea and bleeding was higher than the latter,and It is noteworthy that the bleeding symptoms of the latter were more diversification than the former.For the clinical sign in 2013 and 2015,most dengue cases was main at the rash with symtemic,congestion and pleomophic and abdominal tenderness,but the sign of dengue virus-2 infected patients was more diversity and complexity than those of dengue virus-3..The rashing rate of dengue virus-3 infected patients was higher than dengue virus-2 infected.The analysis was confirmed that the cases of lymph nodes were rare in the dengue popular both in 2013 and 2015.These patients were more prone to low blood pressure and mostly resulting in the complicated DSS in 2013 and 2015.In the relevant biochemical indicators,dengue virus infection is likely to cause of leucopenia and thrombocytopenia in the patients,but the thrombocytopenia incidence was similar both in 2013 and 2015,but dengue virus-2 infected cases were more pronounced on white blood cells and hematocrit.Dengue virus infection on the patients' kidney function was less affected,the cases of urine test showed that proteinuria and hematuria caused by Dengue virus-3 in 2013 was similar to those by dengue virus-2 in 2015.Dengue virus infection easily affected the coagulation function,but dengue virus-2 patients have higher incidence of coagulation abnormalities than those of dengue virus-3,more likely to lead to severe bleeding and disseminated intravascular coagulation.In the liver function test showed that whether it was dengue virus-3 cases or dengue virus-2,their alanine aminotransferase,aspartate aminotransferase and gamma glutamyltransferase were increased in the same time,and the range of damage was l rised within 2 times of upper limition of the normal index.The jaundice index of dengue virus-2 cases was higher than dengue virus-3 cases.Myocardial enzyme test showed that dengue virus-2 was easily led to myocardial injury compared with dengue virus-3,but the most cases have a transient progress.The other indicators such as complement 4,procalcitonin,C-reactive protein,lactate dehydrogenase and ferritin in dengue cases can often help identify different types and the other infectious febrile diseases.In addition,the abdominal imaging detection also indicated that dengue virus infection was low probability in hepatomegaly and splenomegaly.Meanwhile,in the analysis of concomitant diseases that underlying diseases and other infectious diseases were uasally turned nomal dengue patients to the severe.ConclusionThe cases of dengue virus-3 outbroken in Xishuangbanna in 2013 have more typical symptoms and sign,which were mainly high fever,fatigue,muscle aches,loss of appetite,rash and abdominal tenderness,however,the patients of dengue virus-2 in 2015 were in more complex and diverse than those in 2013,which occurred the tendency with the symptoms of respiration and circulation,jaundice,higher proportion of severe cases and higher incidence in coagulopathy,AST,ALT,CK-MB and jaundice index increased.The above results suggested that it is crucial for the medical workers in China according to different symptoms and biochemical indicatersto correct identification of dengue,and take early diagnosis and treatment and isolation of the patients,its can effectively reduce death caused by the severe patients and prevent dengue outbreak.This study should be paid closely attention by the health department in China. |
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