| OBJECTIVE:To retrospectively analyze the epidemiological and clinical data of290 patients with tsutsugamushi disease who were admitted to the First Affiliated Hospital of Dali University from 2017 to 2020,and to explore the epidemiology,clinical features,treatment and impact of organ damage in patients with tsutsugamushi disease in Dali area.These factors will provide a reference for the prevention,diagnosis and treatment of tsutsugamushi disease in Dali in the future.Methods:1.The subjects of the study were 290 inpatients diagnosed with tsutsugamushi in the First Affiliated Hospital of Dali University from January 2017 to September 2020.2.Retrospective analysis combined with epidemiological and clinical data.According to the indicators,patients meeting the inclusion criteria were divided into groups without organ damage and group with organ damage.According to different treatment drugs,they are divided into tetracycline group and doxycycline group.3.Organize the relevant data and establish an Excel database,and use SPSS26.0software for statistical analysis.Measurement data conforming to the normal distribution are expressed as mean±standard deviation(?x±s);measurement data not conforming to the normal distribution are expressed as the median(quartile)[M(Q_L,Q_U)];counting Chi-square test was used for comparison between data groups,and P<0.05 was statistically significant.Results1.The 290 confirmed patients were 109 males and 181 females,with a male-to-female ratio of 1:1.7;the average age of onset was 51.9±13.7 years;the onset time was mostly concentrated in 7 to October;the occupational distribution was dominated by farmers.2.The average number of fever days before hospitalization was 7.1±3.9 days(1-30days);238 cases of chills,accounting for 82.07%;232 cases of anorexia,accounting for80.00%;192 cases of headache,accounting for 66.21%;86 cases of nausea or vomiting,Accounting for 29.66%;3 cases of conjunctival hyperemia,accounting for 1.03%;3cases of rash,accounting for 1.03%;198 cases of eschar or ulcer,accounting for68.28%;20 cases of lymphadenopathy,accounting for 6.90%;1 case of hepatomegaly,accounting for 0.34%;56 cases of splenomegaly,accounting for 19.31%.3.Eosinophils(EO)decreased or disappeared by 65.17%;platelets(PLT)decreased by 28.62%;atypical lymphocytes were 48.28%;albumin(ALB)decreased in196 cases(67.59%);C-reactive protein(CRP)increased High 252 cases(86.90%);200cases were submitted to Widowife test,140 cases were negative(70.00%),and 60 cases were positive(30.00%).4.Complications:102 cases of lung damage,accounting for 35.79%;100 cases of liver damage,accounting for 34.48%;83 cases of blood system damage,accounting for28.62%;12 cases of renal damage,accounting for 4.13%;15 cases of myocardial damage,accounting for 5.17%;3 cases of central nervous system damage,accounting for 1.03%.5.Analysis of related factors of organ damage.Comparison of the two groups shows that the age,PLT,CRP and.ALB.of the.patients.in.the organ.damage group.were significantly.higher than.those.in the non-organ.damage group.,and the.difference.was statistically.significant.(P=0.002,.P<0.001.,P=0.001.,P<0.001.),there.was.no significant.difference.between.the two.groups.in.the.number.of.fever.days.before admission.and the.EO index.6.Treatment and outcome Most patients were treated with tetracycline and doxycycline,150 cases(51.72%)and 98 cases(33.79%)respectively.The treatment effects(cured,effective and ineffective)of the tetracycline group and the doxycycline group were compared,and the two groups were compared and analyzed(χ2=0.552,P=0.759,P>0.05),and the difference was not statistically significant.Conclusions:1.The distribution of tsutsugamushi disease is affected by age,occupation,and season.The symptoms are as follows:the population is mainly between41 and 70 years old;the occupation distribution is mainly farmers;it belongs to the"summer-autumn type"and occurs from July to October.The rate is higher.2.It often starts with fever of unknown cause,eschar or ulcer is of great value for diagnosis,and the decrease of EO and the appearance of atypical lymphocytes have a certain value for the diagnosis of tsutsugamushi disease.3.In the early stage of the disease,the positive rate of the Widowife test is not high,and it cannot be used as a basis for early diagnosis.4.Tsutsugamushi disease can cause damage to a variety of organs.Age,PLT,CRP,ALB are related to organ damage factors.5.The therapeutic effects of tetracycline and doxycycline are roughly the same. |
