CAJ | 학술논문

目的分析肾综合征出血热(HFRS)患者的流行病学及临床特点,为临床治疗HFRS提供诊疗依据.方法收集2014年哈尔滨医科大学附属第一医院收治的104例HFRS患者的流行病学及临床资料,采用回顾性分析方法,分析HFRS患者的年龄、性别、城乡、职业以及发病时间分布,总结患者发病的临床表现,实验室检查结果,治疗与转归.结果在收治的104例HFRS患者中,年龄最大80岁,最小12岁,平均年龄43.46岁,其中30～＜50岁居多,占54.81％(57/104);男性偏多,占78.85％(82/104);以居住在农村的患者居多,占81.73％(85/104).HFRS发病以11月最多,占19.23％ (20/104);8月最少,占2.88％(3/104);其余时间则呈散发.临床分型中以轻、中型居多,有98例,占94.23％;重型、危重型6例,占5.77％.临床表现以发热居多,有94例,占90.38％,其次为乏力、周身酸痛,有89例,占85.57％;多尿期有88例,占84.62％;球结膜水肿有86例,占82.69％;皮肤出血点、淤斑有84例,占80.77％;少尿期有81例,占77.88％.实验室检查,血小板(PLT)减少87例(83.65％);血清肌酐(sCr)升高74例(71.15％);丙氨酸氨基转移酶(ALT)升高74例(71.15％),天门冬氨酸氨基转移酶(AST)升高85例(81.73％),乳酸脱氢酶(LDH)升高96例(92.31％),肌酸激酶(CK)升高31例(29.81％).104例患者全部治愈出院,无死亡病例.结论男性、青壮年、农民为HFRS的主要发病人群,秋季为发病高峰,临床分型以轻中型多见,早期诊断及治疗是改善HFRS患者临床预后的关键.
목적 분석신종합정출혈열(HFRS)환자적류행병학급림상특점,위림상치료HFRS제공진료의거.방법 수집2014년합이빈의과대학부속제일의원수치적104례HFRS환자적류행병학급림상자료,채용회고성분석방법,분석HFRS환자적년령、성별、성향、직업이급발병시간분포,총결환자발병적림상표현,실험실검사결과,치료여전귀.결과 재수치적104례HFRS환자중,년령최대80세,최소12세,평균년령43.46세,기중30～＜50세거다,점54.81％(57/104);남성편다,점78.85％(82/104);이거주재농촌적환자거다,점81.73％(85/104).HFRS발병이11월최다,점19.23％ (20/104);8월최소,점2.88％(3/104);기여시간칙정산발.림상분형중이경、중형거다,유98례,점94.23％;중형、위중형6례,점5.77％.림상표현이발열거다,유94례,점90.38％,기차위핍력、주신산통,유89례,점85.57％;다뇨기유88례,점84.62％;구결막수종유86례,점82.69％;피부출혈점、어반유84례,점80.77％;소뇨기유81례,점77.88％.실험실검사,혈소판(PLT)감소87례(83.65％);혈청기항(sCr)승고74례(71.15％);병안산안기전이매(ALT)승고74례(71.15％),천문동안산안기전이매(AST)승고85례(81.73％),유산탈경매(LDH)승고96례(92.31％),기산격매(CK)승고31례(29.81％).104례환자전부치유출원,무사망병례.결론 남성、청장년、농민위HFRS적주요발병인군,추계위발병고봉,림상분형이경중형다견,조기진단급치료시개선HFRS환자림상예후적관건.
Objective To summarize and analyze the epidemiological and clinical characteristics of hemorrhagic fever patients with renal syndrome (HFRS),so as to provide a basis for prevention and treatment.Methods The epidemiological and clinical data of 104 HFRS patients,who were treated in the First Affiliated Hospital of Harbin Medical University in 2014,were collected.The HFRS patient's age,sex,urban and rural areas,occupation and time of onset distributions,summary onset clinical manifestations,laboratory findings,treatment and outcome were analyzed retrospectively.Results Average age of the 104 cases of HFRS patients was 43.46 years old,the youngest was 12 years old and the oldest was 80 years old.Most of the patients were 30-＜50 years old,which was accounted for 54.81％ (57/104),and most of the patients were male,which was accounted for 78.85％ (82/ 104).Most of the patients lived in rural areas,which was accounted for 81.73％ (85/104).Most patients were onset in November,accounted for 19.23％ (20/104),and the least was in August,accounted for 2.88％ (3/104),and was sporadic in the rest of the year.For the clinical classification,the light type and the moderate type were the largest part,98 cases,accounted for 94.23％,while the severe type and the critically severe type were 6 cases,accounted for 5.77％.The clinical manifestations were as follows:fever majority in 94 cases,accounted for 90.38％,fatigue,aches and pain in 89 cases,accounted for 85.57％;polyuria in 88 cases,accounted for 84.62％;chemosis in 86 cases,accounted for 82.69％;skin bleeding,petechiae in 84 cases,accounted for 80.77％;oliguria in 81 cases,accounted for 77.88％.Laboratory test results were as following:87 cases of blood platelet (PLT) reduced (83.65％),74 cases of serum creatinine (sCr) increased (71.15％),74 cases of alanine aminotransferase (ALT) increased (71.15％),85 cases of aspartate transaminase (AST) increased (81.73％),96 cases of lactate dehydrogenase (LDH) increased (92.31％),and 31 cases of creatine kinase (CK) increased (29.81％).All of the 104 patients were cured,with no death.Conclusions Majority of the HFRS patients are young adults.The peak of the incidence of HFRS lies in Autumn.The proportion of the moderate type is the highest.Early diagnosis and treatment is the key to improve the prognosis of patients with HFRS.