Clinical Experience of Dengue Fever in a Regional Teaching Hospital in Southern Taiwan

南台灣某區域教學醫院登革熱的臨床經驗

羅啓紘(Chi-Hung Lo) ； 班仁知(Ren-Jy Ben) ； 陳朝東(Chaur-Dong Chen) ； 薛肇文(Chao-Wen Hsueh) ； 馮南雄(Nang-Hsiung Feng)

《內科學誌》 20卷3期 (2009/06) Pp. 248-254

https://doi.org/10.6314/JIMT.2009.20(3).08

摘要

2006年國軍高雄總醫院共有37例經血清學診斷為登革熱確定病例。大部分病人發生於九月及十月(23/37, 62%)。病人的平均年齡為45.4±17.7歲。病人平均住院天數爲6.2天。典型症狀有發燒(31/37, 84%)，腸胃道症狀(17/37, 46%)，頭痛(13/37, 35%)，皮疹(13/37, 35%)，肌肉疼痛，關節疼痛以及骨頭痛(13/37, 35%)等。只有2個病人有出血徵候。經RTPCR檢驗結果呈現陽性者有20人。病人平均發燒天數爲6天，從最高體溫降低到正常體溫平均約需要3.8天。白血球減少及血小板降低回復至白血球及血小板正常範圍各需要4.7天及2.1天。在這37個病人中30個病人(81%)有白血球減少的現象，其中又有16個病人的白血球減少較爲嚴重（白血球數目介於1,000至2,000/平方公厘）。27個病人(73%)有血小板過低，其中又有12個病人爲嚴重血小板過低(血小板＜50,000/mm3)的情形。18個病人有PTT延長現象(18/37, 49%)。25個病人(68%)有天門冬安酸胺基轉化(aspartate aminotransferase, AST)上升的情形。此外，有22個病人施行腹部超音波檢查，其中有10位病患有膽囊壁增厚的現象。這37個病患經治療後預後良好。

並列摘要

Thirty-seven serologically confirmed cases of dengue fever were studied during the 2006 in Kaohsiung Armed Forces General Hospital in southern Taiwan. Sixty-two percent of the cases occurred among September and October. The mean age of these patients were 45.4±17.7 years. The mean hospital stay was 6.2 days. Classic signs and symptoms were fever (31/37, 84%), gastrointestinal symptoms (17/37, 46%), headache (13/37, 35%), skin rash (13/37, 35%), myalgia and arthralgia as well as bone pain (13/37, 35%). Only two patients manifested hemorrhagic sign. Positive results for reverse transcriptase-polymerase chain reaction (RT-PCR) developed in 20 patients (20/37, 54%). The average duration of fever from symptom onset was 6 days, with fever peak to normal body temperature of 3.8 days. Prolongation of partial thromboplastin time (PTT) was observed in 18 patients (18/37, 49%). Elevation of aspartate aminotransferase was found in 25 of 37 patients (25/37, 68%). Thrombocytopenia occurred in 27of 37 patients (27/37, 73%) and 12 of them had severe thrombocytopenia (less than 50,000/mm3), while 30patients (30/37, 81%) were leucopenia and most of them (16/37, 43%) had severe leucopenia (white blood cells ranged from 1,000 to 2,000/mm3). The average duration of leucopenia and thrombocytopenia to normal range required 4.7 days and 2.1 days. In addition, the findings of gall bladder wall thickening were demonstrated in 10 of 22(10/22, 45%) abdominal sonographic examinations. All patients recovered with favorable outcome.

並列關鍵字

Dengue fever ； Taiwan