肾综合征出血热患者胰腺功能变化的研究

发布时间：2018-09-13 12:08

【摘要】：目的:研究肾综合征出血热（Hemorrhagic fever with renal syndrome，HFRS）患者不同时期胰腺功能水平（血清淀粉酶、血清脂肪酶）的动态变化及该变化与病情严重程度之间的关系。进而提示临床应重视HFRS的胰腺损害。 方法:我院2010年到2013年收入院治疗的肾综合征出血热患者共22例，采取回顾性分析方法收集资料，比较患者的胰腺功能指标血清淀粉酶（Amy）、血清脂肪酶（Lip），在该病程的发热期、低血压休克期、少尿期、多尿期、恢复期之间的差异及与10例健康对照者之间的差异；比较上述两项指标在轻型、中型、重型和危重型患者中的表达水平与10例健康对照者中的表达水平的差异。 结果：1.统计分析显示：无胰腺功能受损的HFRS患者的住院天数（13.25±3.99天），有胰腺功能受损的HFRS患者的住院天数（30.29±16.26天），二者比较，差异有统计学意义（P0.05）。2.22例HFRS患者中共有14例（63.64%）胰腺功能损害呈现阳性结果，其中轻型组入组有三例，中型组入组有四例，重型组入组有三例，危重型组入组有四例。3.与健康对照组胰腺功能指标相比较，各种分型的肾综合征出血热患者对应的相关指标水平明显高于前者，即（P0.05），且随病情严重程度递增。血清中Amy、Lip浓度由低到高依次为轻型（92.99±8.56U/L，85.06±8.17mmol/L）、中型患者（248.41±16.89U/L，205.98±9.72mmol/L）、重型患者（251.63±23.10U/L，223.63±5.42mmol/L）、危重型患者（253.10±13.49U/L，349.86±28.70mmol/L），各型之间均有显著性差异（P0.05）。4.与健康对照组胰腺功能指标相比较，可见各个时期的肾综合征出血热患者对应的相关指标水平明显高于前者，即（P0.05）。血清中Amy、Lip浓度由低到高依次为少尿期（316.22±52.24U/L，408.89±47.25mmol/L）、低血压休克期（222.26±18.90U/L，305.14±79.71mmol/L）、多尿期（205.75±30.79U/L，243.86±63.97mmol/L）、恢复期（121.32±22.72U/L，131.78±40.06mmol/L）、发热期（105.55±10.30U/L，，94.11±14.41mmol/L），其中发热期与低血压休克期、少尿期与多尿期、多尿期与恢复期相比均有统计学差异（P0.05）。 结论:HFRS对于胰腺功能可以造成损害。HFRS患者胰腺功能指标与患者病情严重密切相关，可作为判断HFRS的分期及严重程度的参考指标，故检测胰腺功能对判断HFRS的分期及严重程度、指导治疗、判断预后具有重要的临床参考价值。
[Abstract]:Objective: to study the dynamic changes of pancreatic function (serum amylase, serum lipase) in patients with hemorrhagic fever with renal syndrome (Hemorrhagic fever with renal syndrome,HFRS) at different stages and the relationship between the changes and the severity of the disease. It is suggested that the pancreatic damage of HFRS should be paid more attention to in clinic. Methods: from 2010 to 2013, 22 patients with hemorrhagic fever with renal syndrome were treated in our hospital from 2010 to 2013. The data were collected by retrospective analysis, and the serum amylase (Amy), serum lipase (Lip), was compared in the fever stage of the disease course. The differences between hypotension shock, oliguria, polyuria, convalescence and 10 healthy controls were compared. The expression levels in severe and critical patients were different from those in 10 healthy controls. The result is 1: 1. Statistical analysis showed that the hospitalization days of HFRS patients without pancreatic function impairment (13.25 卤3.99 days) and HFRS patients with pancreatic dysfunction (30.29 卤16.26 days) were compared. The difference was statistically significant (P0.05) .2.22 cases of HFRS patients, 14 cases (63.64%) showed positive results of pancreatic function damage, of which there were 3 cases in mild group, 4 cases in medium group, 3 cases in severe group and 4 cases in critical type group. Compared with the normal control group, the relative indexes of the patients with hemorrhagic fever with renal syndrome were significantly higher than those of the former (P0.05), and increased with the severity of the disease. The levels of Amy,Lip in serum from low to high were mild (92.99 卤8.56U / L), moderate patients (248.41 卤16.89U / L, 205.98 卤9.72mmol/L), severe patients (251.63 卤23.10U / L, 223.63 卤5.42mmol/L), critical type patients (253.10 卤13.49U / L 349.86 卤28.70mmol/L). Compared with the normal control group, the corresponding indexes of hemorrhagic fever with renal syndrome in each stage were significantly higher than those of the former (P0.05). 琛

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