肾综合征出血热血常规分析及外周血涂片观察

Study on characteristic changes in blood routine analysis and peripheral blood smear examination in patients with hemorrhagic fever with renal syndrome

目的研究肾综合征出血热患者各期血常规的变化,以及外周血涂片中异型淋巴细胞的数量和形态特点。方法分别测定52例肾综合征出血热患者发热期、休克期、少尿期、多尿期和恢复期的血常规,并观察不同时期外周血涂片中异型淋巴细胞的形态和数量,与随机抽取的80例体检人员的血常规检测结果进行对比,并进行统计学分析。结果肾综合征出血热患者外周血白细胞在休克期、少尿期和多尿期均增高,以休克期最为显著(P<0.01);作为肾综合征出血热的主要变化指标,血小板在休克期、少尿期均明显减低,其中以休克期最为明显(P<0.01);而血红蛋白在休克期及少尿期均增高。外周血涂片中,各时期均可观察到异形淋巴细胞,且休克期和少尿期以异型淋巴细胞III型多见,而中性粒细胞胞浆出现中毒颗粒及空泡变性在这两个时期也均可见到。结论肾综合征出血热的血常规检测及外周血涂片检查在疾病发展的各个时期均有其特点,可为疾病的诊断和监测提供依据。

Objective To observe the characteristic changes in routine blood analysis and peripheral blood smear examination in patients with hemorrhagic fever with renal syndrome at various stages. Methods A total of 52 patients with hemorrhagic fever with renal syndrome in vari ous stages were observed, and their results were compared with those of 80 healthy controls in this hospital, and statistical analysis was carried out. Results The counts of white blood cells （WBC） in shock stage and oliguric stage were increased, and it was most obvious in shock stage. The counts of platelets （PLT） in febrile stage, shock stage and oliguric stage were reduced, and this was most obvious in shock stage. The amount of hemoglobin （IIb） in febrile stage and shock stage were increased, and these were most significant in shock stage. Abnormal lymphocytes could be observed in peripheral blood smears in febrile stage, shock stage and oliguric atage, and abnormal lymphocytes in shock stage and olignric stage be longed to type III abnormal lymphocytes, and toxic granules and vacuoles were usually seen in cytoplasm of neutrophils in shock stage and less in oliguric stage. Conclusion Routine blood analysis and peripheral blood smear examination can provide the basis for diagnosis and monitoring in patients with hemorrhagic fever with renal syndrome .