肾综合征出血热多尿期高血压的临床意义

Clinical significance of hypertension in polyuric period of hemorrhage fever with renal syndrome

目的探讨肾综合征出血热(HFRS)并发多尿期高血压的临床意义。方法59例HFRS并发多尿期高血压患者与61例同期住院有多尿期但无高血压患者进行对照,比较主要临床症状、体征及实验室检查。结果肾综合征出血热并发多尿期高血压以中老年患者为多(40～68岁占71.2%);高血压多发生在多尿移行期和多尿早期(88.1%),血压以轻中度升高为主(86.4%);并发高血压组常有头痛、头晕及恶心呕吐(P<0.01),少尿时间较长(P<0.05),多尿期持续时间长(P<0.01),肾功能损害较重,尿素氮、血肌酐水平较高(P<0.01)。结论HFRS并发多尿期高血压患者血压多轻中度升高,大多持续时间较短,预后较好。但可加重肾功能损害,延长多尿期,并发颅内出血、心脏出血者预后较差。

Objective To investigate the clinical significance of hemorrhage fever with renal syndrome （HFRS） complicated with hypertension in polyuric period.Methods Comparison of main clinical symptoms,signs and laboratory tests between 59 cases of HFRS patients complicated with polyuria hypertension and 61 cases of corresponding inpatients in polyuric period of HFRS without hypertension were carried out.Results About 71.2% aged patients （40-68 years old） were more prone to HFRS complicated with hypertension in polyuric period;hypertension most frequently occurred in the early and transitional stage of polyuria （88.1%）.Elevation of blood pressure were mild or moderate （86.4%）.Headaches,dizziness,nausea and vomiting occurred frequently in hypertension group （P0.01）,the stage of oliguria lasted for a longer time （P0.05）,and the stage of polyuria also lasted for a longer time （P0.01）.The renal function was impaired more seriously and the level of blood urea nitrogen,serum creatinine were higher （P0.01）.Conclusions As regards to HFRS patients complicated with polyuria hypertension,the blood pressure was slightly or moderately increased.Most of the high blood pressure were short-termed and with better prognosis.However,renal function might be damaged more seriously and the period of polyuria lasted longer.In addition,such patients complicated with intracranial and heart hemorrhage had poor prognosis.