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目的:了解黑热病发病机制及临床诊断要点。方法:通过病例和实验室诊断分析杜氏利氏曼原虫感染的临床表现,通过患者生活习性分析杜氏利氏曼原虫流行病学,利用RK39抗原筛查及骨髓穿刺涂片直接检测杜氏利氏曼原虫确诊黑热病。结果:确诊为内脏黑热病。给予葡萄糖酸锑钠治疗,剂量为600mg/d,静脉滴注12天,用药3天后体温转入正常,15天后复查骨髓象未见杜氏利氏曼原虫,患者痊愈出院。结论:本例黑热病应该为输入性病例,青海省高寒缺氧,不适宜白蛉生存,使杜氏利氏曼原虫繁衍无传播媒介。骨髓穿刺涂片直接检测杜氏利氏曼原虫是确诊黑热病最有效和准确的方法。
Objective: To understand the pathogenesis and clinical diagnosis of kala-azar. Methods: The clinical manifestations of Leishmania donovani infection were analyzed by case and laboratory diagnosis. The epidemiology of D. donovani was analyzed by the patients’ living habits. RK39 antigen screening and bone marrow biopsy were used to directly detect Leishmania donovani Confirmed kala-azar. Results: The diagnosis of visceral kala-azar. Given antimony gluconate treatment, the dose of 600mg / d, intravenous infusion of 12 days, 3 days after treatment into normal body temperature, 15 days after the review of bone marrow did not see Leishmania doxylum, patients were discharged. Conclusion: In this case, kala-azar should be an imported case. Alpine hypoxia in Qinghai Province is not suitable for the survival of the white catfish. Direct detection of bone marrow biopsy Leishmania donovani is the most effective and accurate method for the diagnosis of kala-azar.