山东省青岛市肾综合征出血热的流行病学及临床特征分析

Epidemiological and clinical characteristics of hemorrhagic fever with renal syndrome in Qingdao,Shandong Province

目的了解青岛市肾综合征出血热(HFRS)的流行病学及相关临床特征,为临床诊疗HFRS提供相关依据。方法采用回顾性分析方法,收集2014年1月至2018年12月青岛大学附属医院确诊的104例HFRS患者的流行病学及临床资料,分析患者的一般情况、临床症状、实验室检查及接触史等。结果104例HFRS患者年龄为10~87岁,其中男性78例、女性26例。患者主要居住于农村,占90.38%(94/104);在肾病科就诊54例,占51.92%;发病集中在10月至次年1月,占68.27%(71/104)。临床表现为发热98例,占94.23%;恶心呕吐66例,占63.46%;头晕头痛57例,占54.81%。实验室检查多见血小板降低,尿蛋白与隐血阳性,D-二聚体、C反应蛋白与降钙素原升高;仅8例具有直接、间接或可疑接触史。结论HFRS发病临床特征不典型,主要症状为发热、恶心呕吐、头晕头痛,男性多见,居住地主要是农村,接触史大多不明确。诊断应与实验室检查结果相结合,及早治疗,以改善临床预后。

Objective To investigate the epidemiology and related clinical features of hemorrhagic fever with renal syndrome(HFRS)in Qingdao,and provide relevant evidence for clinical diagnosis and treatment.Methods The retrospective analysis method was used to collect the epidemiological and clinical data of 104 patients with HFRS diagnosed in the Affiliated Hospital of Qingdao University from January 2014 to December 2018,and the general condition,clinical symptoms,laboratory examination and exposure history of the patients were analyzed.Results One hundred and four patients with HFRS were aged from 10 to 87 years old,including 78 males and 26 females;mainly living in rural areas,accounting for 90.38%(94/104);and 54 cases from the Department of Nephrology,accounting for 51.92%.October to January of the following year was the main onset time,accounting for 68.27%(71/104).The clinical manifestations were 98 cases of fever,accounting for 94.23%;66 cases of nausea and vomiting,accounting for 63.46%;and 57 cases of dizziness and headache,accounting for 54.81%.Laboratory examination showed more thrombocytopenia,urinary protein and occult blood positive,D-dimer elevation,C-reactive protein and procalcitonin elevation.Only 8 cases had a history of direct,indirect or suspicious contact.Conclusions The clinical features of HFRS are atypical.The main symptoms are fever,nausea and vomiting,dizziness and headache.Men are higher than women.The place of residence is mainly in rural areas.The exposure history is mostly unclear.Diagnosis should be combined with laboratory findings and early treatment to improve clinical outcomes.