严重过敏反应患者的常见实验室检查变化特点

Change of laboratory test of Patients with Anaphylaxis

目的分析严重过敏反应患者的实验室检查结果及其影响因素。方法回顾性分析1990～2013年住院患者中42例发生严重过敏反应的一般情况、临床表现、血压心率变化、实验室检查结果及影响因素。结果患者平均年龄（39±16）岁，男：女一1：2.2；发作时收缩压及舒张压均较基础血压明显下降（P〈0.01），发作心率较基础心率明显增加（P〈0.01）；严重过敏反应临床表现中以皮肤表现最常见（73.8％）。实验室检查结果：血氧饱和度较低患者皮肤症状发生率低（50.0％）、呼吸系统症状发生率高（83.3％），白细胞（P〈0.01）、中性粒细胞增加（P〈0.01）、血钾（P〈O.01）、血钙水平下降（P〈O.01）、血糖升高（P〈0.01），嗜酸性粒细胞、血钠、血氯、肝肾功能无明显变化，血钙低者皮肤表现多发（P〈0.05）。结论严重过敏反应发作时血压明显下降、心率明显增加；临床表现中以皮肤表现最常见；血氧饱和度较低患者皮肤症状发生率低、呼吸系统症状发生率高，白细胞、中性粒细胞增加、血钾、血钙水平下降、血糖升高，嗜酸性粒细胞、血钠、血氯、肝肾功能无明显变化，血钙低者皮肤表现多发。

Objective To analyze the laboratory test results and influence factors of the patients with anaphy- laxis. Methods We analyzed the general condition, clinical manifestation, change of blood pressure and heart rate,la- boratory test results and influence factors of 42 patients with anaphylaxis from 1990 to 2013 retrospectively. Results The mean age was 39±16 years old. The ratio of male and female was 1：2.2. Dropping in systolic and diastolic blood pressure（P〈0.01）and increase in heart rate（P〈0.01）. The most common clinical manifestation involved the dermal system（73.8%）. Respiratory system（83.3%）involved was more common than dermal system（50.0%）whenblood oxygen saturation declined. White blood cell（P〈0.01 ）, neutrophil（P〈0.01）, serum potassium（P〈0.01）, se- rum calcium（P〈0. 01） decreased and blood glucose （P〈0.01 ） increased, but eosinophil, serum sodium, chlorine and function of liver and kidney were stable. Dermal system involved was more common when serum calcium was low（P〈O.05）. Conclusion Blood pressure drop and heart rate increased obviously when anaphylaxis attacked. The most common clinical manifestation involved the dermal system. Respiratory system involved was more common than der- mal system when blood oxygen saturation declined. White blood cell, neutrophil, serum potassium, serum calcium de- creased and blood glucose increased, but eosinophil, serum sodium, chlorine and function of liver and kidney were sta-ble. Dermal system involved was more common when serum calcium was low.