876例肾综合征出血热患者的流行病学和临床特征的回顾性分析

A retrospective analysis on epidemiological and clinical features of 876 cases of hemorrhagic fever with renal syndrome

目的研究肾综合征出血热（hemorrhagic fever with renal syndrome,HFRS）的流行特征、临床特点及危险因素,为HFRS的预防控制和临床诊断提供依据。方法收集湖北省近5年HFRS临床诊断病例和实验室确诊病例的个案调查资料876例,采用回顾性分析方法,应用SPSS 17.0对数据进行统计分析。结果患者平均年龄为（47.67±13.97）岁,以男性农民为主,症状以轻型、中型为主（80.26%）。临床表现则多见发热（96.69%）、乏力（92.58%）、蛋白尿（88.93%）、血小板减少（80.59%）、白细胞升高（63.70%）等。相关暴露因素中,主要有鼠或鼠排泄物接触史。结论湖北省HFRS患者以轻型和中型为主,同时出现发热、血小板减少和蛋白尿可作为HFRS早期诊断的参考依据;应加强农村防鼠灭鼠工作,开展重点地区重点人群的健康教育工作,提高疫苗接种率。

Objective To study the epidemiological characteristics, clinical features and risk factors of hemorrhagic fever with renal syndrome （ HFRS）, so as to provide guidance for prevention and clinical diagnosis of HFRS. Methods The investigation data of 876 clinical diagnosis and laboratory confirmed cases of HFRS in Hubei over the past 5 years were collected and retrospective analysis was conducted. The statistical analysis was carried out with SPSS 17. 0 software. Results The average age of the cases was （47.67 ± 13.97 ） years. Most of the patients were male farmers with mild and moderate clinical classification（80. 26% ）. The major clinical manifestations were fever（96.69% ）, fatigue（92. 58% ）, proteinuria （88. 93% ）, thrombocytopenia（80. 59% ）, leukocytosis（63.70% ）, etc. Most of the patients had a history of exposure to rat or its excreta. Conclusions The clinical classification of the patients were mainly mild and moderate. There is a certain reference value for the early diagnosis of patients with fever, thrombocytopenia and proteinuria. We should strengthen work in rodent control, focus on health education of key population in the key areas and improve the vaccination rate.