3种甲状腺激素水平登革热病例临床特征分析

Clinical characteristics of dengue fever patients with three types of thyroid hormone levels

目的探讨西双版纳州三种甲状腺激素水平登革热病例的临床特征,为医疗卫生部门制定登革热诊疗方案和控制登革热流行提供依据。方法对2013年和2015年西双版纳州的三种甲状腺激素水平感染登革热住院病例进行病例的症状、体征和相关生化指标回顾性分析。结果甲状腺激素降低的登革热病例肌肉酸痛和肾功能异常发生率高,但凝血功能异常、GGT升高、C4升高的发生率相对较低,甲状腺激素增多登革热病例胆红素升高、凝血功能异常、心肌酶谱升高概率高于降低组,但白细胞减少概率低于后者。结论 2013年和2015年西双版纳州暴发登革疫情中甲状腺激素降低的登革热病例肾损伤发生率高,甲状腺激素升高登革热病例重症化倾向较甲状腺激素降低组明显。

Objective To study the clinical features of dengue fever patients with three types of thyroid hormone levels in Xishuangbanna Prefecture, so as to and provide evidences for formulating the diagnosis and treatment program of dengue fever and control strategy of dengue fever transmission. Methods The clinical data of dengue fever patients with three types of thyroid hormone levels were collected and analyzed for their symptoms and biochemical indicators in 2013 and 2015 in The People＇ s Hospital of Xishuangbanna Prefecture and The Hospital of Infectious Diseases of Xishuangbanna Prefecture. Results In the dengue fever patients with reduced thyroid hormone levels, the incidence rates of muscle ache and abnormal renal function were higher, but the incidence rates of coagulation dysfunction, gamma glutamyl transferase （GGT） increase and complement 4 （C4） increase were lower. The incidence rates of elevated bilirubin, coagulation dysfunction and myocardial enzymes increase in the dengue fever patients with increased thyroid hormone levels were higher than those in the dengue fever patients with reduced thyroid hormone levels, but the incidence of leukopenia of the former was significantly lower than that of the latter. Conclusions For the clinical characteristic of dengue fever cases in the outbreaks of dengue fever epidemic in Xishuangbanna Prefecture, in 2013 and 2015, the dengue fever patients with reduced thyroid hormone levels have the higher incidence of kidney injury. However, the dengue fever patients with increased thyroid hormone levels have the trend of serious illness compared with the reduced group obviously.