血液净化治疗流行性出血热合并急性肾衰竭15例临床分析

目的分析和探讨血液净化治疗流行性出血热合并急性肾衰竭的疗效。方法15例流行性出血热合并急性肾衰竭患者为研究对象,均行血液净化治疗。观察患者治疗结果,治疗前及治疗后第3、10天的血常规、肾功能、肝功能指标。结果15例患者中,14例治愈出院,1例因多器官功能衰竭死亡。住院时间(17.50±8.11)d。治疗前、治疗后第3天、治疗后第10天,患者的白细胞计数(WBC)分别为(15.87±4.78)、(11.57±3.01)、(7.24±1.42)×10^(9)/L,中性粒细胞百分比(NEUT%)分别为(72.84±11.54)%、(67.53±10.88)%、(60.76±11.59)%,血小板计数(PLT)分别为(60.73±31.31)、(111.27±43.80)、(186.6±61.71)×10^(9)/L,C反应蛋白(CRP)分别为(50.89±22.39)、(26.93±18.19)、(4.48±3.16)mg/L。患者治疗前、治疗后第3天、治疗后第10天的WBC、NEUT%、PLT、CRP比较,差异具有统计学意义(P<0.05)。治疗后第3、10天,患者的WBC、CRP均低于治疗前,PLT均高于治疗前,差异具有统计学意义(P<0.05);治疗后第10天,患者的WBC、CRP低于治疗后第3天,PLT高于治疗后第3天,NEUT%低于治疗前,差异有统计学意义(P<0.05)。患者治疗后第3天与治疗后10天的NEUT%比较,差异无统计学意义(P>0.05)。患者治疗前、治疗后第3天、治疗后第10天的血尿素氮(BUN)、血肌酐(Cr)、胱抑素C(Cys-C)、β_(2)微球蛋白(β_(2)-M)比较,差异具有统计学意义(P<0.05)。治疗后第3、10天,患者的BUN、Cr、Cys-C、β_(2)-M均较治疗前降低,且治疗后第10天低于治疗后第3天,差异有统计学意义(P<0.05)。患者治疗前、治疗后第3天、治疗后第10天的血白蛋白(ALB)、谷草转氨酶(AST)比较,差异具有统计学意义(P<0.05)。治疗后第3、10天,患者ALB均较治疗前升高,AST均较治疗前降低,差异有统计学意义(P<0.05)。治疗后第10天,患者ALB高于治疗后第3天,AST低于治疗后第3天,谷丙转氨酶(ALT)低于治疗前,差异有统计学意义(P<0.05)。结论血液净化治疗流行性出血热合并急性肾衰竭疗效显著,能明显改善患者肾功能、肝功能及炎症反应。

Analysis on the Moist Potential Vorticity and Conditional Symmetric Instability of a Rainstorm

[Objective] The research aimed to analyze the moist potential vorticity (MPV) and conditional symmetric instability (CSI) of a rainstorm in Guangxi in the prior flood season. [Method] Based on the conventional observation data, precipitation data from the automatic station and 1°×1° six-hourly reanalyzed data from NCEP, MPV and CSI in a rainstorm process which occurred in the prior flood season in Guangxi were analyzed. The characteristics of MPV component and role of CSI before and after the rainstorm occurrence were discussed. [Result] The dense belt of isoline in the southeast of MPV1 positive-value area (MPV2 negative-value area) at 925 hPa, the underneath of sloping MPV1 positive-value column (MPV2 negative-value column) on the profile map and the underneath of dense belt of θe isoline had the good corresponding relationships with the falling zone of strong precipitation. After the system developed strongly, the enhancements of gradient and intensity of MPV1 and MPV2 predicted the rainstorm increase. In the beginning period of strong precipitation occurrence, the convective instability at 850-650 hPa co-existed with CSI. The convective instability and vertical movement played the main role. In the middle and latter periods of strong precipitation, the high-altitude weak cold air further invaded southward. It triggered the release of unstable energy, and compelled that the original sloping θe dense belt became steep. It was favorable for the development of sloping vorticity, and the atmosphere gradually turned into the neutral state of convection. CSI and ramp motion played the major role. Then, the rainstorm continued. [Conclusion] The research provided the theory basis for the application of MPV and CSI into the local routine business.