肾综合征出血热患者各病期各型胆红素的动态检测

Significance of Serum Bilirubin in Hemorrhagic Fever with Renal Syndrome

目的 :研究肾综合征出血热患者各病期各型胆红素的动态变化及临床意义。方法 :使用美国 EKTACHE75 0 XRC Analyzer生化分析仪对肾综合征出血热患者各病期丙氨酸氨基转移酶 (AL T)、总胆红素 (TBIL )、直接胆红素(DBIL)、非结合胆红素 (Bu)、结合胆红素 (Bc)、δ胆红素 (δ- BIL)进行测定。结果 :与对照组相比 ,发热期除 δ- BIL 外 ,其他指标均相差显著 ,少尿期 AL T、TBIL、Bu、Bc、DBIL 变化最大 ,多尿期患者血清 δ- BIL 含量最高 ,恢复 Bu、Bc趋于正常 ,而 AL T和 TBIL相差显著 ,δ- BIL和 DBIL相差极为显著。 Bu/ TBIL全病程呈逐渐下降趋势 ,Bc/ TBIL开始逐渐上升在少尿期达到高峰 ,之后逐渐下降 ,而 δ- BIL/ TBIL 在全病程始终呈逐渐上升趋势。结论 :对肾综合征出血热患者各病期各型胆红素的动态监测有助于肾综合征出血热的诊断、分期及预后判断。

Objective To evaluate the significance of serum bilirubins in hemorrhagic fever with renal syndrome(HFRS).Methods The concentrations of total, direct, conjugated, unconjugated and delta bilirubin were measured by EKTACHE 750XRC analyzer.Results The concentrations of total, direct conjugated and unconjugated bilirubin increased significantly since febile phase,and oliguria phase was the highest among all phases. Delta bilirubin in serum increased slightly in febile phase, significantly in oliguria phase,and the highest phase was polyuria phase.Only the level of conjugated and unconjugated bilirubin returned to normal in convalescent phase. Conclusion The results indicated that dynamic measurement of direct,conjugated,unconjugated and delta bilirubin might be valuable in patients with HFRS.