登革热的临床特征分析和诊断体会

发布时间：2018-03-02 11:00

本文关键词： 登革热体征和症状诊断　出处：《中国全科医学》2017年21期 　论文类型：期刊论文

【摘要】：目的总结登革热的临床特征和诊断体会,提高登革热的临床诊治技能。方法回顾性分析广州医科大学附属第一医院2014年6月—2016年10月诊治的650例登革热患者的临床资料,分析其中238例于发病第1、3、5天行血常规检查患者的白细胞计数、血小板计数变化规律。结果650例登革热患者的主要临床表现为发热(100.0%,650例)、乏力(96.2%,625例)、肌痛(89.1%,579例)、恶心(86.2%,560例)、畏寒(74.2%,482例)、皮疹(70.0%,392例)、腹泻(49.5%,322例)、呕吐(43.2%,281例)等。丙氨酸氨基转移酶(ALT)升高(49.4%,321例),天冬氨酸氨基转移酶(AST)升高(40.4%,263例),肌酸激酶(CK)升高(48.9%,318例),乳酸脱氢酶(LDH)升高(34.8%,226例),尿蛋白阳性(34.0%,221例)。238例患者发病第1、3、5天外周血白细胞计数减少者所占比例分别为4.2%(10例)、83.2%(198例)、92.9%(221例);血小板计数减少者所占比例分别为3.4%(8例)、15.1%(36例)、67.6%(161例)。结论近3年广州登革热患者临床表现以典型登革热症状为主,大部分患者白细胞计数减少开始出现于发病第3天,血小板计数减少开始出现于发病第5天;部分患者有肝、肾和肌肉损害。
[Abstract]:Objective to summarize the clinical characteristics and diagnostic experience of dengue fever and to improve the skills of clinical diagnosis and treatment of dengue fever. Methods the clinical data of 650 patients with dengue fever treated in the first affiliated Hospital of Guangzhou Medical University from June 2014 to October 2016 were retrospectively analyzed. The white blood cell count of 238 patients who were examined by routine blood examination on the 3rd day after the onset of the disease was analyzed. Results the main clinical manifestations of 650 patients with dengue fever were as follows: fever 100.050 cases, fatigue 96.2C 625 cases, muscle pain 89.1m 579 cases, nausea 86.2i 579 cases, nausea 86.2i 582 cases, rashes 70.0392 cases, diarrhea 49.5U 322 cases, vomiting 43.2d 281 cases), etc. The main clinical manifestations of 650 cases of dengue fever were: 100.0 cases of fever, 96.2 cases of fatigue, 579 cases of muscle pain, 86.2 cases of nausea, 482 cases of chills, 70.0392 cases of rashes, 322 cases of diarrhea, 281 cases of vomiting. There were 321 cases of elevated aminoaminotransferase (alt), 40.4263 cases of aspartate aminotransferase (AST), 48.9% of creatine kinase (CK), 34.8% of lactate dehydrogenase (LDH), and 221 cases of urinary protein positive. The proportion of cell count decrease in 10 cases (83.2c) and that of thrombocytopenia in 8 cases (15. 1%) were 4. 2% respectively. Conclusion in recent 3 years, the clinical manifestations of dengue fever in Guangzhou are mainly typical symptoms of dengue fever, and the proportion of patients with thrombocytopenia is 3. 4% and 15. 1% respectively. The leukopenia began on the 3rd day and the platelet count decreased on the 5th day, and some of the patients had liver, kidney and muscle damage.
【作者单位】：广州医科大学附属第一医院感染内科;
【分类号】：R512.8

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