黄少娟:核心概念、文献检索、数据采集、统计分析、文章准备、文章编辑、文章审查;李淑芳、陈文元:数据采集、数据分析、文章编辑;陈星、梁艳桂、马晓军、黄清华:数据采集;吴小堃,张改:文献检索、数据分析、文章准备、文章编辑;陈苹:核心概念、文章审查
收稿日期: 2025-08-17
网络出版日期: 2026-04-28
基金资助
广州中医药大学2025年护理“基础强化”项目——一级学科能力提升计划(GZY2025GB0923)
Clinical characteristics observation and nursing care of 67 patients with Chikungunya hemorrhagic fever
Received date: 2025-08-17
Online published: 2026-04-28
Supported by
The Guangzhou University of Chinese Medicine 2025 Nursing “Foundation Strengthening”Program-First-Level Discipline Capability Enhancement Project(GZY2025GB0923)
目的 探讨67例基孔肯雅热患者的流行病学特征、临床特点与实验室检查变化,为临床护理实践提供参考。方法 采用回顾性研究方法,纳入2025年7月17日至8月5日广东省某三级甲等医院住院的67例基孔肯雅热患者为研究对象,收集并分析其人口学资料、流行病史、临床症状与体征、中医证型、基础疾病及实验室检测指标。结果 流行病学特征中,女43例(64.18%),男24例(35.82%),年龄14~85(49.19±18.28)岁,病例集中于7月下旬(62.69%);临床特征以轻症为主(98.51%),主要临床表现为关节炎(86.57%)、皮疹(71.64%)、发热(67.16%)“三联征”;中医辨证以湿热蕴结证最常见(34.33%);合并2种及以上基础疾病的患者占比26.87%,其中≥60岁以上老年患者占72.2%。实验室指标特征中,基孔肯雅热病毒核酸检测CT值为(28.27±7.59);炎症指标(白细胞介素-6、C反应蛋白、肿瘤坏死因子)及D-二聚体普遍升高;肾小球滤过率、血清钾及白蛋白普遍降低。结论 2025年广东省基孔肯雅热疫情呈季节性聚集,以青壮年女性轻症患者多见,关节炎突出,伴炎症激活与代谢紊乱。提示在蚊媒传染病流行季节,护理人员预检分诊中应重视对高风险人群的早期识别,并基于中医证型与实验室检测指标,加强对炎症与凝血等异常指标的动态监测及个体化症状管理,以优化临床结局。
黄少娟 , 李淑芳 , 陈文元 , 陈星 , 梁艳桂 , 马晓军 , 黄清华 , 吴小堃 , 张改 , 陈苹 . 67例基孔肯雅热患者的临床特征观察及护理[J]. 中华急危重症护理杂志, 2026 , 7(5) : 574 -580 . DOI: 10.3761/j.issn.2096-7446.2026.05.010
Objective To explore the epidemiological characteristics,clinical manifestations,and laboratory findings of patients with Chikungunya fever,and to offer evidence-based references for clinical nursing practice. Methods A retrospective analysis was performed on 67 hospitalized patients diagnosed with Chikungunya fever who were admitted to a tertiary grade A hospital between July 17 and August 5,2025. We collected and analyzed the data,including demographic features,epidemiological history,clinical symptoms and signs,traditional Chinese medicine (TCM) syndrome patterns,comorbidities,and laboratory findings. Results Among the 67 patients,43(64.18%) were female and 24(35.82%) were male,with an age range of 14-85 years(49.19 ± 18.28). Cases were predominantly clustered in late July(62.69%). The clinical characteristics are mainly mild(98.51%),with the main clinical mani-festations being the triad of arthritis(86.57%),rash(71.64%),and fever(67.16%). The most common TCM syndrome pattern was damp-heat accumulation syndrome(34.33%). Comorbidities(≥2 types) were present in 26.87% of patients,and 72.2% of these comorbid patients were aged ≥60 years. Laboratory findings showed that the CT value of the Chikungunya virus nucleic acid test was (28.27±7.59),markers(IL-6,CRP,TNF-α) and D-dimer levels were generally elevated,while the estimated glomerular filtration rate(eGFR),serum potassium,and albumin levels were commonly reduced. Conclusion The 2025 Chikungunya fever outbreak in Foshan,Guangdong Province,exhibited obvious seasonal clustering,with mild cases being more common in young and middle-aged females. Arthritis was a prominent clinical feature,accompanied by inflammatory activation and metabolic disturbances. During the endemic season of mosquito-borne diseases,nursing staff should prioritize the early identification of high-risk groups during pre-admission triage. Guided by TCM syndrome differentiation and laboratory findings,dynamic monitoring of inflammatory and coagulation markers should be strengthened,and individualized symptom management implemented to improve clinical outcomes.
| [1] | de Lima Cavalcanti TYV, Pereira MR, de Paula SO, et al. A re-view on chikungunya virus epidemiology,pathogenesis and current vaccine development[J]. Viruses, 2022, 14(5):969. |
| [2] | de Roo AM, Vondeling GT, Boer M, et al. The global health and economic burden of chikungunya from 2011 to 2020:a model-driven analysis on the impact of an emerging vector-borne disease[J]. BMJ Glob Health, 2024, 9(12):e016648. |
| [3] | 林苗, 李华, 黄吉城, 等. 广东检验检疫局发现中国内地首例输入性基孔肯雅热病例[J]. 中国国境卫生检疫杂志, 2008, 31(4):221-223,236. |
| Lin M, Li H, Huang JC, et al. First imported chikungunya fever case at Guangzhou Baiyun international port[J]. Chin J Front Health Quar, 2008, 31(4):221-223,236. | |
| [4] | 田丽丽, 刘婷, 杨鹏, 等. 北京市首例基孔肯雅热病例流行病学调查[J]. 国际病毒学杂志, 2011, 18(2):41-44. |
| Tian LL, Liu T, Yang P, et al. Investigation of the first Chikungunya fever case in Beijing[J]. Interational J Virol, 2011, 18(2):41-44. | |
| [5] | 阳帆, 许少坚, 张仁利, 等. 深圳市输入性基孔肯雅热病例的流行病学和病原学特征分析[J]. 中华实验和临床病毒学杂志, 2015, 29(4):306-309. |
| Yang F, Xu SJ, Zhang RL, et al. Analysis on the epidemiology and etiologic characteristics of first imported Chikungunya fever case in Shenzhen in 2010[J]. Chin J Exp Clin Virol, 2015, 29(4):306-309. | |
| [6] | 王金章, 阚乃鹏, 张拥军, 等. 2018年福建省输入性基孔肯雅热的病原学特征[J]. 中华实验和临床病毒学杂志, 2019, 33(3):253-256. |
| Wang JZ, Kan NP, Zhang YJ, et al. Etiological characteristics of an imported Chikungunya fever epidemic in Fujian Province in 2018[J]. Chin J Exp Clin Virol, 2019, 33(3):253-256. | |
| [7] | 李幸乐, 金湘东, 马建敏, 等. 2019年河南省一例输入性基孔肯雅热病例的发现与处置[J]. 疾病监测, 2020, 35(3):202-205. |
| Li XL, Jin XD, Ma JM, et al. Detection and management of an imported case of Chikungunya fever in Henan[J]. Dis Surveillance, 2020, 35(3):202-205. | |
| [8] | 何方玲, 张恒娇, 王娟, 等. 湖南省首起输入性基孔肯雅热疫情的发现与病原学诊断[J]. 中华实验和临床病毒学杂志, 2020, 34(2):175-179. |
| He FL, Zhang HJ, Wang J, et al. Discovery and etiological diagnosis of the first imported Chikungunya fever epidemic in Hunan Province[J]. Chin J Exp Clin Virol, 2020, 34(2):175-179. | |
| [9] | Yang CF, Su CL, Hsu TC, et al. Imported chikungunya virus strains,Taiwan,2006-2014[J]. Emerg Infect Dis, 2016, 22(11):1981-1984. |
| [10] | Lee N, Wong CK, Lam WY, et al. Chikungunya fever,Hong Kong[J]. Emerg Infect Dis, 2006, 12(11):1790-1792. |
| [11] | Pan JH, Fang CF, Yan JY, et al. Chikungunya fever outbreak,Zhejiang Province,China,2017[J]. Emerg Infect Dis, 2019, 25(8):1589-1591. |
| [12] | 刘巧谊, 胡文穗, 攸小瑾, 等. 广州市输入性蚊媒传染病流行病学特征分析[J]. 医学动物防制, 2023, 39(3):245-248. |
| Liu QY, Hu WS, You XJ, et al. Epidemiological characteristics of imported mosquito-borne infectious diseases in Guangzhou[J]. J Med Pest Control, 2023, 39(3):245-248. | |
| [13] | 国家卫生健康委办公厅. 国家中医药局综合司关于印发基孔肯雅热诊疗方案(2025年版)的通知[EB/OL]. (2025-07-31)[2025-08-06]. https://www.nhc.gov.cn/ylyjs/gzdt/202507/c592a4f82dd7405e9be5302e4147c0c7.shtml. |
| Office of the National Health Commission. Comprehensive Department of the National Administration of Traditional Chinese Medicine-Notice on issuing the diagnosis and treatment plan for chikungunya fever(2025 Edition)[EB/OL]. (2025-07-31)[2025-08-06]. https://www.nhc.gov.cn/ylyjs/gzdt/202507/c592a4f82dd7405e9be5302e4147c0c7.shtml. . | |
| [14] | 国家卫生健康委办公厅. 基孔肯雅热诊断[EB/OL]. (2018-03-06)[2025-08-06]. https://www.nhc.gov.cn/wjw/s9491/201803/a5993b86fc024b7c8ad72f0f16c52090.shtml. |
| Office of the National Health Commission. Diagnosis of Chikun-gunya fever[EB/OL]. (2018-03-06)[2025-08-06]. https://www.nhc.gov.cn/wjw/s9491/201803/a5993b86fc024b7c8ad72f0f16c52090.shtml. | |
| [15] | Wu D, Wu J, Zhang QL, et al. Chikungunya outbreak in Guangdong Province,China,2010[J]. Emerg Infect Dis, 2012, 18(3):493-495. |
| [16] | 卢诗颖, 郑丹文, 洪新田, 等. 基于横断面调查的基孔肯雅热患者中医证候特征研究[J]. 北京中医药大学学报, 2025, 48(11):1531-1539. |
| Lu SY, Zheng DW, Hong XT, et al. Characteristics of traditional Chinese medicine syndromes in patients with Chikungunya hemorrhagic fever:a cross-sectional study[J]. J Beijing Univ Tradit Chin Med, 2025, 48(11):1531-1539. | |
| [17] | Bartholomeeusen K, Daniel M, LaBeaud DA, et al. Chikungunya fever[J]. Nat Rev Dis Primers, 2023, 9:17. |
| [18] | Bezerra WP, Moizéis RNC, Salmeron ACA, et al. Innate immune response in patients with acute Chikungunya disease[J]. Med Microbiol Immunol, 2023, 212(4):279-290. |
| [19] | Vidal OM, Acosta-Reyes J, Padilla J, et al. Chikungunya outbreak(2015) in the Colombian Caribbean:Latent classes and gender differences in virus infection[J]. PLoS Negl Trop Dis, 2020, 14(6):e0008281. |
| [20] | 王晶晶, 王莹, 田晓晓, 等. 基于C-反应蛋白水平探讨不同炎症状态下血清维生素的变化特点[J]. 肠外与肠内营养, 2024, 31(5):262-267,274. |
| Wang JJ, Wang Y, Tian XX, et al. Study on the changes of serum vitamin in different inflammatory states based on CRP levels[J]. Parenter Enter Nutr, 2024, 31(5):262-267,274. | |
| [21] | 梁运光, 谢周华, 黎彦君, 等. 50例基孔肯雅热患者的流行病学及临床特征分析[J]. 广西医学, 2025, 47(10):1450-1453. |
| Liang YG, Xie ZH, Li YJ, et al. Epidemiological and clinical characteristics of 50 patients with chikungunya fever:an analytic study[J]. Guangxi Med J, 2025, 47(10):1450-1453. | |
| [22] | 刘礼文, 楼莲青, 李晓飞, 等. 以淋巴细胞减少为主要表现的基孔肯雅热六例临床分析[J]. 中华临床感染病杂志, 2020, 13(2):125-127. |
| Liu LW, Lou LQ, Li XF, et al. Clinical analysis of 6 cases of Chikungunya fever with lymphopenia as the main presentation[J]. Chin J Clin Infect Dis, 2020, 13(2):125-127. | |
| [23] | 梅红, 杨竞旋, 劳兆延, 等. 儿童基孔肯雅热343例临床特点分析[J]. 中国感染控制杂志, 2025, 24(11):1558-1562. |
| Mei H, Yang JX, Lao ZY, et al. Clinical characteristics of Chikungunya fever in 343 children[J]. Chin J Infect Control, 2025, 24(11):1558-1562. | |
| [24] | 李雅玲, 吴晓强, 曾炜, 等. 血管超声联合血浆D-二聚体、凝血功能及外周血炎性指标对老年髋部骨折患者下肢深静脉血栓的诊断价值[J]. 中国老年学杂志, 2025, 45(16):3939-3943. |
| Li YL, Wu XQ, Zeng W, et al. Diagnostic value of vascular ultrasound combined with plasma D-dimer,coagulation function and inflammatory indexes of peripheral blood for deep venous thrombosis of lower limbs in elderly patients with hip fracture[J]. Chin J Gerontol, 2025, 45(16):3939-3943. | |
| [25] | Kosugi T, Eriguchi M, Yoshida H, et al. Serum high-density lipoprotein cholesterol levels and the risk of kidney function decline:the Japan specific health checkups(J-SHC) study[J]. J Atheroscler Thromb, 2025, 32(4):407-420. |
| [26] | 杨维芳, 褚宏亮, 徐燕. 我国基孔肯雅热流行现状及媒介伊蚊控制研究进展[J]. 江苏预防医学, 2025, 36(5):529-532. |
| Yang WF, Chu HL, Xu Y. Current situation of Chikungunya fever outbreaks and research progress in Aedes mosquito control in China[J]. Jiangsu J Prev Med, 2025, 36(5):529-532. |
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