78例肾综合征出血热多器官损害的临床特征及影像学表现

目的:总结分析肾综合征出血热的临床特征及影像学表现,提高其早期诊断符合率.方法:回顾性分析78例确诊为肾综合征出血热患者的临床及影像资料,总结其临床及影像学特征.结果:肾综合征出血热患者最常见的临床表现为发热(72/78,92.31％)、少尿或无尿(65/78,83.33％)、呕吐腹泻(63/78,80.77％)、头痛...

Clinical and imaging features of multiple organ damage of hemorrhagic fever with renal syndrome in 78 patients

Objective:To analyze the clinical and imaging features of hemorrhagic fever with renal syndrome(HFRS).Methods:The clinical and imaging data of 78 HFRS patients were retrospectively reviewed.Results:The most common clinical manifestations of HFRS were fever(72/78,92.31%),oliguria or anuria(65/78,83.33%),vomiting and diarrhea(63/78,80.77%),headache,low back pain and abdominal pain(47/78,60.26%),facial congestion,neck and chest congestion(49/78,62.82%).Other manifestations included scattered bleeding spots throughout the body(22/78,28.21%),facial or lower limb edema(19/78,24.36%),and even shock(6/78,7.69%).The most common abnormalities in laboratory tests were leukocyte elevation,platelet reduction,transaminase elevation,urea nitrogen and creatinine elevation,prolonged coagulation time,and urinary protein positivity;amylase elevation and troponin elevation were accompanied in some patients.58 patients(74.36%)were positive for HFRS virus IgM and IgG.The most common chest and abdomen CT manifestations were kidney swelling(42/78,53.85%),perirenal fascia thickening with exudation(63/78,80.77%),peritoneal effusion(56/78,71.79%),pleural effusion and atelectasis(54/78,69.23%).Other manifestations included pancreatitis(31/78,39,74%),pericardial effusion(22/78,28.21%),bilateral pulmonary infection(18/78,23.08%),decreased liver density(11/78,14.10%)and renal subcapsular hemorrhage(9/78,11.54%),etc.Cranial MR showed abnormal signal in pituitary gland(2/78,2.56%)and brain hemorrhage(1/78,1.28%).Conclusion:HFRS tends to show multiple organ damages with complex clinical characteristics.Imaging may be valuable for disease severity assessment and guiding clinical decision.