盐源家鼠型肾综合征出血热临床资料比较分析

Comparative analysis clinical data of rattus type hemorrhagic fever with renal syndrome （HERS） in Yanyuan

目的在于摸清盐源县高海拔疫区家鼠型肾综合征出血热（HERS）的临床特点，提高诊断水平，减少误诊误报，漏诊、漏报、提高防治水平。方法收集盐源县医院2002～2003年住院治疗的300例临床病例与山西太原市105例家鼠型HFRS病例，以及成都市116例病例进行临床症状、体征比较，经统计学处理判断是否有差别存在。结果临床症状方面盐源病例在起病急缓、乏力、全身疼痛、腰痛、头痛等“三痛”症状较成都资料更为突出。成都市病例：胃肠道症状如恶心、呕吐重于盐源病例。体征方面：盐源病例在“三红”方面不及成都病例明显。盐源病例软腭有出血点占70．33％，87％病人有肾区扣痛。与太原市105例资料比较：“三痛”方面，盐源病例腰痛更为突出占94．00％，但出血倾向和胃肠道症状，“三红”体征均较太原资料轻。化验检测，尿蛋白、白细胞升高，异形淋巴细胞等都不如太原资料突出。

Objective To find out the clinical features of the rattus type of hemorrhagic fever with renal syndrome （HFRS） in high - altitude areas of Yanyuan County, and improve diagnosis level, reduce misdiagnosis of false positives, missed, omissions to improve the level of the disease control. Methods To compare the clinical symptoms and signs of 300 cases in hospital treatment of clinical cases in Yanyuan County Hospital from 2002 to 2003 with 105 cases in Taiyuan of Shanxi and 116 cases in Chengdu to do statistical test for exploring wethere there is a significant Differences exist. Results Clinical symptoms in Yanyuan cases disease onset process, fatigue, body pain, back pain, headache symptoms information are more prominent than the case in Chengdu. Chengdu cases： gastrointestinal symptoms such as nausea, vomiting are more serious than the Yanyuan Case. Signs ： the cases of yanyuan signs that their body pain, back pain, headache are no significant than Chengdu＇ s. 70.33% of cases soft palates are bleeding in yanyuan, and 87% of the patients have the percussion District kidney pain. To compared with the Taiyuan＇ s case： there are 94.00% of 105 Taiyuan＇ s cases have body pain, back pain, headache and they are more prominent than yanyuan＇ s cases. But yanyuan＇ s cases hemorrhagic tendency and gastrointestinal symptom（GIS） are lightly thanTaiyuan＇ s. The Laboratory testing showing： the urine protein, interleukin increased, differentiated cell and so on are manifest to tayuan＇ s cases.