23例肾综合征出血热并发窦性心动过缓患者的诊治分析

发布时间：2018-03-28 04:26

本文选题：肾综合征出血热　切入点：心动过缓　出处：《中国全科医学》2017年30期

【摘要】：目的探讨肾综合征出血热并发窦性心动过缓的临床特点、治疗以及预后情况。方法回顾性分析济宁医学院附属医院2014年1月—2016年1月收治的肾综合征出血热患者110例,其中23例患者并发窦性心动过缓作为试验组,余87例肾综合征出血热未并发窦性心动过缓的患者作为对照组。收集试验组患者发生窦性心动过缓前及对照组的血常规、心肌酶谱、电解质、肝肾功能等实验室检查指标,并进行比较。分析23例肾综合征出血热并发窦性心动过缓患者的诊治情况。结果试验组血小板计数、HCO_3~-低于对照组,血糖高于对照组(P0.05)。两组患者其余指标比较,差异无统计学意义(P0.05)。23例肾综合征出血热并发窦性心动过缓患者中男14例,女9例;平均年龄(42.4±13.0)岁。23例肾综合征出血热并发窦性心动过缓患者中肾综合征出血热轻型17例,中型5例,重型1例;窦性心动过缓发生在肾综合征出血热多尿期18例(78.3%),少尿期2例(8.7%),发热期2例(8.7%),低血压休克期1例(4.3%);窦性心动过缓常发生在发热后(8.2±2.0)d,对症治疗(6.2±2.2)d后心率恢复至参考范围。结论肾综合征出血热并发窦性心动过缓患者常发生血小板计数、HCO_3~-、血糖异常,对其进行对症治疗后,随着原发疾病的缓解,心率即可恢复至参考范围,预后佳。
[Abstract]:Objective to investigate the clinical features, treatment and prognosis of hemorrhagic fever with renal syndrome complicated with sinus bradycardia. Methods 110 patients with hemorrhagic fever with renal syndrome treated in the affiliated Hospital of Jining Medical College from January 2014 to January 2016 were retrospectively analyzed. 23 patients with sinus bradycardia were used as experimental group and 87 patients with hemorrhagic fever with renal syndrome (HFRS) without sinus bradycardia as control group. The blood routine of patients with sinus bradycardia before sinus bradycardia and control group were collected. Myocardial enzyme spectrum, electrolytes, liver and kidney function were compared and compared. The diagnosis and treatment of 23 patients with hemorrhagic fever with renal syndrome complicated with sinus bradycardia were analyzed. Results the platelet count in the test group was lower than that in the control group. The blood glucose level was higher than that in the control group (P 0.05). There was no significant difference between the two groups in other indexes. There were 14 males and 9 females in the 23 patients with hemorrhagic fever with renal syndrome complicated with sinus bradycardia. The mean age was 42.4 卤13.0 years. Among the 23 patients with hemorrhagic fever with renal syndrome complicated with sinus bradycardia, 17 were mild hemorrhagic fever with renal syndrome, 5 were moderate, and 1 was severe. Sinus bradycardia occurred in 18 patients with haemorrhagic fever with renal syndrome in polyuria stage, in oliguria stage in 2 patients with diabetes, in febrile phase in 2 patients with hypobaric shock in 1 patient with hypobaric shock, in patients with sinus bradycardia occurred at 8.2 卤2.0 days after fever, and after symptomatic treatment of 6.2 卤2.2 days, the heart rate recovered to the reference level. Scope. Conclusion patients with hemorrhagic fever with renal syndrome complicated with sinus bradycardia often have abnormal blood glucose and platelet count. With the remission of the primary disease, the heart rate can be recovered to the reference range and the prognosis is good.
【作者单位】：济宁医学院附属医院血液净化科;济宁医学院附属医院全科医学科;济宁医学院附属医院肾内科;
【基金】：济宁市科技计划立项项目(2014jnnk04)——尿NGAL、KIM-1对流行性出血热急性肾损伤诊断价值的临床研究
【分类号】：R512.8;R541.72

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