登革热并发肝损害的相关因素分析

The factors associated with hepatic lesion in dengue fever patients

目的探讨登革热的成年患者并发肝损害的相关因素。方法回顾分析2006年8～9月广州市第八人民医院住院的成年登革热患者共299例,病毒基因型均为I型,按年龄、性别匹配分成两组,其中一组为无并发肝损害组作为对照组、共134例,另一组为发生肝损害组、共165例,两组分别在体温峰值、有无皮疹、有无使用退热药、血白细胞水平、血小板水平方面进行比较。结果两组在体温峰值和皮疹的发生方面差异有统计学意义(P<0.01;P<0.05),但两组在有无使用退热药和外周血白细胞水平、血小板水平方面差异无统计学意义。结论对于2006年广州市成年登革热患者,体温峰值越高或者发生皮疹者,发生肝损害的机会越大。其发生机制可能与免疫病理有关。

Objective To investigate the factors associated with hepatic lesion in dengue fever patients. Methods Two hundred and ninety - nine adult dengue fever patients hospitalized and treated in Guangzhou Municipal No. 8 people, s Hospital between August and September in 2006 were divided into two groups balanced by age and sex. The viral genotype of all patients, were dengue 1 virus. In the control group there were 134 patients without hepatic lesion. In the observation group there were 165 patients with hepatic lesion. All patients,data were retrospectively analyzed based on the parameters of peak value of body temperature, skin rash, use or without use of antipyrestic, level of leukocyte count and platelet count. Results There significant differences were observed between two groups on the peak value of body temperature,s peak value （ P = 0.005 〈 0.01） ,and occurrence of skin rash （ P =0. 027 〈 0.05）. But there no significant differences between the two groups were observed in use of antipyrestic, the level of leukocyte count and platelet count. Conclusion The higher of peak value of body temperature and occurrence of skin rash in adults dengue fever patients in Guangzhou in 2006 the more chance for them to have hepatic lesion. The pathogenesis of hepatic lesion may be associated with the immunopathology.