가을철 유행하는 급성열성질환의 혼합감염 양상

Abstract

본 연구는 가을철 급성열성질환인 쯔쯔가무시병의 단독감염과 신증후군 출혈열과의 혼합감염 시 임상증상 및 혈액검사의 양상을 보고자 전라남도 일개종합병원에서 최근 5년간 쯔쯔가무시병 혈청학적 확진검사에서 항체역가가 1:80이상인 양성 환자 221명을 분석하였다. 쯔쯔가무시병 단독감염 환자는 183명이며, 신증후군 출혈열과의 혼합감염 환자는 38명이었다. 연령별 환자발생은 70세 이상에서 가장 많이 발생하였으며, 성별 분포는 남성이 70명(31.7%), 여성이 151명(66.8%)으로 여성에서 다소 높았다. 발생 시기는 10월과 11월에 전체 발생율의 70% 이상을 차지하였다. 대상자의 임상증상은 발열(p=0.028)과, 가려움증(p=0.000), 근육통(p=0.000)에서 단독감염보다 혼합감염 시 유의하게 높았으며, 혈액검사 상 AST(p=0.000), ALT (p=0.000), 혈액요소질소(p=0.002), 총 빌리루빈(p=0.000)수치가 단독감염보다 혼합감염 시 유의하게 높았다. In this study, for behavior clinical signs and blood tests when autumn sudden fevered disease, Tsutsugamushi Disease is Single infected with mixing hemorrhagic fever with renal syndrom.221 positive patients, who have antibody titer more than 1:80 in serologic examination of Tsutsugamushi Disease in a general hospital, Jeollanam-do province, were adopted as a Analysis. in respect of frequency. Single infection patients of Tsutsugamushi Disease were 183 and mixed infection patients with Hemorrhagic Fever with Renal Syndrome were 38. In respect of age, patients over the 70's were mostly infected. In respect of sex, male patients were 70(31.7%) and female patients were 151(66.8%) Women were more infected than men. In respect of outbreak time, the more than 70% disease occurrence of all was charged in October and November and it also occurred in spring. In the clinical signs, fever(p=0.028), urtication(p=0.000) and muscle pain(p=0.000) of mixed infection was more higher than single infection. And in the blood tests, AST(p=0.000), ALT(p=0.000), blood urea nitrogen(p=0.002), total bilirubin(p=0.000) value of mixed infection was more higher than single infection.