新型布尼亚病毒感染致发热伴血小板减少综合征临床特点及血常规和血清酶学分析

发布时间：2018-03-14 12:59

本文选题：布尼亚病毒科感染　切入点：血小板减少　出处：《安徽医药》2016年05期 　论文类型：期刊论文

【摘要】：目的探讨发热伴血小板减少综合征的流行病学、临床特征,通过血常规和血清酶学动态变化预测重症患者预后。方法对70例发热伴血小板减少综合征病例资料进行回顾性分析,比较痊愈组和死亡组病程中临床表现和实验室检查结果,应用t检验和Spearman分析发现危重症及死亡患者预后相关危险因素。结果患者以中老年农民为主,多在5~7月份发病,17.39%患者有明确蜱叮咬史。14例患者死亡,病死率为20%。症状主要表现为发热、畏寒寒战、全身不适、乏力、肌肉酸痛、纳差、腹泻、恶心、呕吐和头痛及咳嗽咳痰等。体征主要表现脑膜刺激征阳性,颈部、腋窝、腹股沟淋巴结肿大伴触痛阳性。实验室指标异常主要为WBC、PLT降低,ALT、AST、CK、LDH升高。结论发热伴血小板减少综合征临床表现多种多样,常常伴有实验室检测指标明显异常,出现多脏器功能衰竭、神经系统损害、出血倾向及肺部重症感染,甚至感染性休克的患者预后差,死亡率高。在诊疗过程中,宜采取有效对症支持治疗,尤其对重症患者需加强实验室指标的监测和病情监护。
[Abstract]:Objective to investigate the epidemiology and clinical characteristics of febrile patients with thrombocytopenia syndrome (FRS) and to predict the prognosis of severe patients by blood routine examination and dynamic changes of serological enzymes. Methods the data of 70 patients with fever and thrombocytopenia syndrome were retrospectively analyzed. The clinical manifestations and laboratory results in the cured group and the dead group were compared. T test and Spearman analysis were used to find the risk factors related to the prognosis of the critically ill and the dead patients. In May and July, 17.39% of the patients had definite history of tick bites. 14 patients died, and the mortality rate was 20.1. The main symptoms were fever, chills, general discomfort, fatigue, muscle soreness, anorexia, diarrhea, nausea. Vomiting, headache, cough and expectoration. Signs are mainly positive for meningeal stimulation, neck, armpit, etc. The main abnormality of laboratory indexes was the increase of LDH in alt ASTCKT. Conclusion the clinical manifestations of fever with thrombocytopenia syndrome are various, often accompanied by obvious abnormality of laboratory test indexes, and the clinical manifestations of the patients with Fever and Thrombocytopenia syndrome are various. Patients with multiple organ failure, nervous system damage, bleeding tendency, severe pulmonary infection and even septic shock have poor prognosis and high mortality. Especially for severe patients, it is necessary to strengthen the monitoring of laboratory indicators and disease monitoring.
【作者单位】：安徽医科大学第二附属医院肝病科;安徽大学经济学院;
【分类号】：R511

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