肾综合症出血热合并肝损害160例临床分析

Clinical Analysis of 160 Cases of Hemorrhagic Fever with Renal Syndrome and Liver Damage Complication

目的；分析肾综合症出血热（HFRS）并发肝损害的发生率、严重程度及其与HFRS病情的关系。方法：收集我院2000年1月至2007年12月收治的226例HFRS患者的临床资料，对并发肝损害的160例患者进行回顾性分析。结果：160例HFRS合并肝损害患者占HFRS患者的70．8‰，均有不同程度的食欲减退，恶心呕吐等消化道症状，肝区叩击痛41倒；肝肿大40例，重度黄疸2例。160例ALT均有不同程度升高．伴有血清TBn升高46倒，伴有血清A1b降低97例，51.2％的患者肝损害发生于少尿期，8．7％发生于发热期．重度肝损害多发生于重型、危重型。肝损害7天内恢复者72例，8～14天恢复者44例，15～21天恢复者38例，22～28天恢复者4例。160例有肝损害的患者中，2例因重度肝损害死亡。其余患者肝损害均随原发病的好转而恢复正常，无慢性化倾向。结论：肝损害程度与HFRS临床分型呈正相关，HFRS引起的肝损害是可逆的，随着原发病的好转而恢复，无慢性化倾向，其恢复时间取决于临床分型和肝损害程度。

Objective：To investigate the clinical characteristics of hemorrhagic fever with renal syndrome （HFRS） and liver damage complication, the extent of liver damage and its relationship with HFRS. Methods：Collecting clinical data of treated 226 HFRS cases from January 2000 to December 2007. Analyzing 160 cases with liver damage complication. Results： 160 patients with liver damage were 70.8% in 226 HFRS cases, they had varying gastrointestinal symptoms and signs. Two patients died in 160 cases. The remaining patients improved and with non--chronic tendency. Conclusion：The liver damage of HFRS is positive correlation with its clinical classification. HFRS caused liver damage is reversible with the improvement of primary disease and non--chronic tendency. The recovery time depends on the clinical classification and extent of liver damage.