Blum Johannes, Schmid Caecilia, Burri Christian
Swiss Tropical Institute, Medical and Diagnostic Services, Socinstrasse 57, 4002 Basel, Switzerland.
Acta Trop. 2006 Jan;97(1):55-64. doi: 10.1016/j.actatropica.2005.08.001. Epub 2005 Sep 12.
The clinical symptoms and signs of patients with second stage HAT are described for a large cohort of patients treated in a prospective multicentre, multinational study. Special emphasis is given to the influence of disease stage (duration, number of WBC in CSF) and patient age to the clinical picture. Even though the frequencies of symptoms and signs are highly variable between centres, the clinical picture of the disease is similar for all countries. Headache (78.7%), sleeping disorder (74.4%) and lymphadenopathy (56.1%) are the most frequent symptoms and signs and they are similar for all stages of the disease. Lymphadenopathy tends to be highest in the advanced second stage (59.0%). The neurological and psychiatric symptoms increase significantly with the number of WBC in the CSF indicating the stage of progression of the disease. Pruritus is observed in all stages and increases with the number of WBC in CSF from 30 to 55%. In children younger than 7 years, lymphadenopathy is less frequently reported (11.8-37.3%) than in older children or adults (56.4-61.2%). Fever is most frequently reported in children between 2 and 14 years of age (26.1-28.7%) and malnutrition is significantly more frequently observed in children of all ages (43-56%) than in adults (23.5%).
在一项前瞻性多中心、跨国研究中，对大量接受治疗的二期非洲锥虫病（HAT）患者的临床症状和体征进行了描述。特别强调了疾病阶段（病程、脑脊液中白细胞数量）和患者年龄对临床表现的影响。尽管各中心症状和体征的出现频率差异很大，但该病在所有国家的临床表现相似。头痛（78.7%）、睡眠障碍（74.4%）和淋巴结病（56.1%）是最常见的症状和体征，且在疾病的各个阶段都相似。淋巴结病在二期晚期最为常见（59.0%）。随着脑脊液中白细胞数量的增加，神经和精神症状显著增加，这表明疾病的进展阶段。瘙痒在所有阶段均有出现，且随着脑脊液中白细胞数量的增加，发生率从30%升至55%。在7岁以下儿童中，淋巴结病的报告频率（11.8 - 37.3%）低于年龄较大的儿童或成人（56.4 - 61.2%）。发热在2至14岁儿童中报告频率最高（26.1 - 28.7%），所有年龄段儿童中营养不良的发生率（43 - 56%）显著高于成人（23.5%）。
