中华急诊医学杂志
中華急診醫學雜誌
중화급진의학잡지
CHINESE JOURNAL OF EMERGENCY MEDICINE
2015年
4期
380-385
,共6页
蒋舒玉%吕菁君%魏捷%孙胜男%王蕊%杨卫泽%田丹
蔣舒玉%呂菁君%魏捷%孫勝男%王蕊%楊衛澤%田丹
장서옥%려정군%위첩%손성남%왕예%양위택%전단
新型布尼亚病毒%发热伴血小板减少综合征%危险因素%肝功能%凝血功能%回顾性分析
新型佈尼亞病毒%髮熱伴血小闆減少綜閤徵%危險因素%肝功能%凝血功能%迴顧性分析
신형포니아병독%발열반혈소판감소종합정%위험인소%간공능%응혈공능%회고성분석
Novel bunyavirus%Severe fever with thrombocytopenia syndrome%Risk factors%Liver function%Coagulation%Retrospective analysis
目的 探讨影响发热伴血小板减少综合征(SnTS)预后的临床指标,为SFTS危重病例的病程变化、影响预后的危险因素提供参考依据.方法 武汉大学人民医院从2012年5月至2014年7月收治17例发热伴血小板减少综合征确诊病例.收集17例患者的流行病学史、临床表现、并发症、体检和实验室检查结果等临床资料进行回顾性分析,比较痊愈组和死亡组入院时(发病第6天)以及入院3d时(发病第9天)的临床表现和实验室检查结果,应用Spearman相关性分析影响SFTS患者预后的危险因素.结果 老年男性患者出现精神神经症状、肝功能明显异常、凝血功能明显异常提示病情危重,预后极差.SFTS患者AST、ALT明显升高,AST539 U/L(229.73,545.4) U/ (r=0.597,P=0.015)是影响预后的危险因素.血氨升高提示严重的肝脏功能损伤,常常合并神经系统症状,表现为烦躁、谵妄、不自主的四肢颤动.SFTS患者出现血小板显著下降,口腔溃疡/牙龈出血,消化道出血提示病情危重;PLT 24.88×109 L-1 (12.75,35.00) ×109L-1 (r=0.557,P=0.005)或者APTT86.06s (66.88,114.18)s(r=0.798,P=0.001)或者D-二聚体9.79 mg/L (4.09,16.51) mg/L(r=0.597,P=0.015)是影响预后的危险因素.结论 发病第9天(高峰期第3天)的AST、WBC、PLT、Am、D-二聚体是影响发热伴血小板减少综合征患者预后的危险因素.
目的 探討影響髮熱伴血小闆減少綜閤徵(SnTS)預後的臨床指標,為SFTS危重病例的病程變化、影響預後的危險因素提供參攷依據.方法 武漢大學人民醫院從2012年5月至2014年7月收治17例髮熱伴血小闆減少綜閤徵確診病例.收集17例患者的流行病學史、臨床錶現、併髮癥、體檢和實驗室檢查結果等臨床資料進行迴顧性分析,比較痊愈組和死亡組入院時(髮病第6天)以及入院3d時(髮病第9天)的臨床錶現和實驗室檢查結果,應用Spearman相關性分析影響SFTS患者預後的危險因素.結果 老年男性患者齣現精神神經癥狀、肝功能明顯異常、凝血功能明顯異常提示病情危重,預後極差.SFTS患者AST、ALT明顯升高,AST539 U/L(229.73,545.4) U/ (r=0.597,P=0.015)是影響預後的危險因素.血氨升高提示嚴重的肝髒功能損傷,常常閤併神經繫統癥狀,錶現為煩躁、譫妄、不自主的四肢顫動.SFTS患者齣現血小闆顯著下降,口腔潰瘍/牙齦齣血,消化道齣血提示病情危重;PLT 24.88×109 L-1 (12.75,35.00) ×109L-1 (r=0.557,P=0.005)或者APTT86.06s (66.88,114.18)s(r=0.798,P=0.001)或者D-二聚體9.79 mg/L (4.09,16.51) mg/L(r=0.597,P=0.015)是影響預後的危險因素.結論 髮病第9天(高峰期第3天)的AST、WBC、PLT、Am、D-二聚體是影響髮熱伴血小闆減少綜閤徵患者預後的危險因素.
목적 탐토영향발열반혈소판감소종합정(SnTS)예후적림상지표,위SFTS위중병례적병정변화、영향예후적위험인소제공삼고의거.방법 무한대학인민의원종2012년5월지2014년7월수치17례발열반혈소판감소종합정학진병례.수집17례환자적류행병학사、림상표현、병발증、체검화실험실검사결과등림상자료진행회고성분석,비교전유조화사망조입원시(발병제6천)이급입원3d시(발병제9천)적림상표현화실험실검사결과,응용Spearman상관성분석영향SFTS환자예후적위험인소.결과 노년남성환자출현정신신경증상、간공능명현이상、응혈공능명현이상제시병정위중,예후겁차.SFTS환자AST、ALT명현승고,AST539 U/L(229.73,545.4) U/ (r=0.597,P=0.015)시영향예후적위험인소.혈안승고제시엄중적간장공능손상,상상합병신경계통증상,표현위번조、섬망、불자주적사지전동.SFTS환자출현혈소판현저하강,구강궤양/아간출혈,소화도출혈제시병정위중;PLT 24.88×109 L-1 (12.75,35.00) ×109L-1 (r=0.557,P=0.005)혹자APTT86.06s (66.88,114.18)s(r=0.798,P=0.001)혹자D-이취체9.79 mg/L (4.09,16.51) mg/L(r=0.597,P=0.015)시영향예후적위험인소.결론 발병제9천(고봉기제3천)적AST、WBC、PLT、Am、D-이취체시영향발열반혈소판감소종합정환자예후적위험인소.
Objective To investigate risk factors of the prognosis of patients with severe fever with thrombocytopenia syndrome (SFTS).Methods From May 2012 to July 2014,17 cases of severe fever with thrombocytopenia syndrome in Renmin Hospital of Wuhan University were treated.Clinical data including history of epidemiology,clinical manifestations,complications,physical examination and laboratory test results on admission and the third day after admission were retrospectively analyzed and compared with the death group and recovery group by application of Spearman correlation analysis.Results Elderly male patients with neuropsychiatric symptoms,or abnormal liver function,or abnormal blood clotting function had higher risk of the poor prognosis.In SFTS patients,AST,ALT was significantly increased,AST 539 U/L (229.73,545.4) U/L (r =0.597,P =0.015) was a risk factor affecting prognosis.Elevated blood ammonia indicated serious liver dysfunction and neurological dysfunction which were manifested as irritability,delirium,and trembling limbs.In SFTS patients,platelets were significantly decreased accompanied with mouth ulcers / bleeding gums,gastrointestinal bleeding.PLT 24.88 × 10 9/L-1 (12.75,35.00) ×10 9/L-1 (r=0.557,P=0.005) or APTT 86.06 s (66.88,114.18) (r=0.798,P=0.001) or D-dimmer 9.79 mg / L (4.09,16.51) mg/L (r =0.597,P =0.015) are risk factors affecting poor prognosis.Conclusions On the third days after admission,AST,WBC,PLT,APTT,Ddimmer are risk factors for prognosis of patients with severe fever with thrombocytopenia syndrome infected by a novel bunyavirus.
