肾综合征出血热37例临床分析

Hemorrhagic Fever with Renal Syndrome:A clinical analysis of 37 cases

目的总结肾综合征出血热(HFRS)的临床特点,提高临床医生对本病的认识。方法对我院收治的37例HFRS患者的临床表现、实验室检查结果及治疗方法进行回顾性分析。结果37例患者中,发热37例(100.0%),头痛21例(56.8%),恶心、呕吐16例(43.2%),腰痛14例(37.8%),腹痛12例(32.4%),低血压10例(27.0%),眼眶痛4例(10.8%);蛋白尿33例(89.2%),血小板减少33例(89.2%),肝功能损害32例(86.5%);B超示:胆囊双边征16例(43.2%),双肾增大13例(35.1%),肝大或脾大6例(16.2%)。37例患者在发热的第4～12天出现HFRS抗体阳性反应。结论以发热、低血压、出血、肾功能损害等为突出表现者,要考虑到HFRS的可能,早期进行HFRS病原学或抗体检测可以确诊。

Objective To summarize the clinical feature of hemorrhagic fever with renal syndrome （HFRS） in order to deepen recognition of clinical doctors to the disease. Methods Retrospective study was used for clinical manifestation, auxiliary examination, treatment of 37 patients with HFRS in our hospital. Results Among all the 37 patients there were 37 （ 100.0% ） with fever, 21 （56. 8% ） with headache, 16 （43.2%） with nausea and vomiting, 14 （37. 8% ） with lumbago, 12 （32. 4% ） with abdominal pain, 10 （27. 0% ） with hypotension, and 4 （ 10. 8% ） with orbital pain; and there were 33 （89. 2% ） with proteinuria, 33 （89. 2% ） with thrombocytopenia, and 32 （86. 5 % ） with hepatic function injury. The B - Uhrasonogaphy indicated there were 16 （43.2%） with double layer structure of gallbladder wall, 13 （35. 1% ） with enlargement of both kidneys, 6 （ 16. 2% ） with hepatomegaly or splenomeglaly. During the 4 - 12th days of fever, there 37 cases who got positive reaction of HFRS antibody. Conclusion HFRS may be considered for a case with remarkable fever, hypotension, hemorrhage and renal impairment. An earlier etiology or antibody test may diagnose it.