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目的了解温州市甲型副伤寒的流行规律、临床特征和耐药性特点,为今后防治工作提供科学依据。方法病例来自1998年1月~2009年12月温州医学院附属第一医院收治的甲型副伤寒住院病人。结果共收集157例甲型副伤寒患者。发病年龄主要集中在20~50岁人群中,约占80%。2001-2003年为发病高峰,尤其是2003年,病例数为85例。冬春季节是甲型副伤寒的好发月份。甲型副伤寒高热多见,超过39℃的病例占80.3%。没有发现1例玫瑰疹。合并基础疾病的占33.8%。平均住院时间为17.68 d。白细胞计数介于(2~8)×109/L占88.5%,嗜酸粒细胞消失占51.7%。红细胞沉降率升高不明显,小于60 mm/1 h末占88.57%。中毒性肝炎的发生率为90.2%,但肝功能损害程度相对较轻,丙氨酸氨基转移酶≤3倍正常值占84.3%。肥大反应阳性率7.7%。除头孢哌酮、头孢呋辛、复方磺胺甲噁唑、氨苄西林耐药性稍高外,其他抗菌药物敏感性均在90%以上。结论温州市的甲型副伤寒具有自身的流行规律、临床特征和药敏试验特点,本研究对甲型副伤寒的早期诊断和合理治疗具有指导作用。
Objective To understand the prevalence, clinical characteristics and drug resistance of Paratyphoid A in Wenzhou, and to provide a scientific basis for future prevention and treatment. Methods From January 1998 to December 2009, the cases were treated inpatients with Paratyphus A from the First Affiliated Hospital of Wenzhou Medical College. Results A total of 157 cases of paratyphoid fever were collected. Age of onset mainly concentrated in the 20 to 50-year-olds, accounting for about 80%. The peak incidence in 2001-2003, especially in 2003, the number of cases was 85 cases. Spring and winter is a good month of Paratyphoid fever. Paratyphoid fever more common, more than 39 ℃ cases accounted for 80.3%. 1 case of roseola was not found. 33.8% of them had basic diseases. The average length of stay was 17.68 days. White blood cell count was (2 ~ 8) × 109 / L accounted for 88.5%, eosinophils disappeared accounted for 51.7%. Erythrocyte sedimentation rate was not significantly increased, less than 60 mm / 1 h accounted for 88.57%. The incidence of toxic hepatitis was 90.2%, but the degree of liver damage is relatively mild, alanine aminotransferase ≤ 3 times normal accounted for 84.3%. The positive rate of hypertrophy was 7.7%. In addition to cefoperazone, cefuroxime, sulfamethoxazole compound, ampicillin slightly higher drug resistance, the other antibacterials were more than 90% sensitivity. Conclusions Parasit al in Wenzhou has its own epidemic rules, clinical characteristics and drug susceptibility testing characteristics. This study may provide guidance for the early diagnosis and reasonable treatment of Paratyphoridis.