中国麻风皮肤病杂志 ›› 2025, Vol. 41 ›› Issue (1): 43-47.doi: 10.12144/zgmfskin202501043

• 临床研究 • 上一篇    下一篇

18例成人重症水痘临床分析

杜清1，陈红1，赵玄1，冉启惠1，邓超1，赵本南2   

  1. 1成都市公共卫生临床医疗中心重症二科，四川成都，610061； 2成都市公共卫生临床医疗中心内一科，四川成都，610061
  • 出版日期:2025-01-15 发布日期:2024-12-23

Analysis of clinical characteristics in 18 adults with severe varicella

DU Qing1, CHEN Hong1, ZHAO Xuan1, RAN Qihui1, DENG Chao1, ZHAO Bennan2   

  1. 1 The Second Ward of ICU, Public Health Clinical Center of Chengdu, Chengdu 610061, China; 2 The First Ward of Internal Medicine, Public Health Clinical Center of Chengdu, Chengdu 610061, China
  • Online:2025-01-15 Published:2024-12-23

PDF (PC)

50

摘要： 目的：分析成人重症水痘患者的临床特征，提高对该病的认识。方法：回顾性分析我院重症二科2018年1月至2024年3月收治的18例成人重症水痘患者的临床资料。结果：18例患者中男12例、女6例，平均年龄32.1岁（18～50岁），9例（50.0%）因器官移植、类风湿关节炎等基础疾病长期使用免疫抑制药物。异常实验室结果主要包括血小板计数降低12例(66.7%)、肝酶升高15例(83.3%)、心肌酶升高18例(100%)、N氨基末端脑钠肽升高15例(83.3%)、D-二聚体升高16例(88.9%)、降钙素原升高14例(77.8%)。6例（33.3%）因治疗效果不佳自动出院（3例）或死亡（3例）。15例（83.3%）合并肺部感染，其中11例合并Ⅰ型呼吸衰竭。结论：成人重症水痘患者以男性居多，死亡率较高。免疫抑制个体是成人重症水痘的高发人群。成人重症水痘合并肺部感染患者Ⅰ型呼吸衰竭发生率高。

关键词: 重症水痘, 成年人, 水痘-带状疱疹病毒, 肺炎

Abstract: Objective: To analyze the clinical characteristics of adult patients with severe varicella, and enhance the understanding of this disease. Methods: The clinical data of 18 patients with severe varicella admitted to our hospital from January 2018 to March 2024 were retrospectively analyzed. Results: Of the 18 patients, 12 were males and 6 were females. The average age was 32.1 years (ranging from 18 to 50). Nine patients (50.0%) received long-term immunosuppressive drugs due to organ transplantation, rheumatoid arthritis, or other underlying diseases. Multiple laboratory abnormalities included decreased platelet count (12 cases, 66.7%), elevated liver enzyme (15 cases, 83.3%), elevated myocardial enzyme (18 cases, 100%), elevated NT-pro BNP(15 cases, 83.3%), elevated D-dimer(16 cases, 88.9%), and elevated procalcitonin(14 cases, 77.8%). Six patients(33.3%) discontinued treatment due to poor outcomes, of them, 3 cases died. There were 15 patients infected with pneumonia, and 11 patients had type Ⅰ respiratory failure. Conclusions: Severe varicella is more prevalent in adult males, and has a relatively high mortality rate. Immunocompromised adults are at higher risk for severe varicella infection. Type Ⅰ respiratory failure is frequently observed in adults with severe varicella complicated with pulmonary infection.

Key words: severe varicella, adult, varicella-zoster virus, pneumonia