305例流行性出血热肝脏损害的临床观察

对305例确诊的流行性出血热患者作了肝功能检查,异常者251例(82.29%),主要为血清 ALT 升高(82.29%)及血清白蛋白降低(71.8%)。发热期肝功能异常者为74.55%,休克期96.77%,少尿期91.95%。绝大岁数病例进入恢复期后肝功能逐渐恢复正常,未恢复者则与既往乙型病毒性肝炎有关。肝功能损害程度与病情轻重有关。对死亡8例肝穿及1例尸检肝组织光镜检查证实有肝细胞变性和坏死。上述结果表明出血热患者普遍存在出血热肝炎。

CLINCAL OBSERVATION OF LIVER DAMAGE IN 305 CASES WITH EPIDEMIC HEMORRHAGIC FEVER

Liver fumctions were tested in 305 cases with epidemic hemorrhagic fever(EHF) .The results show that 251 cases had abnormal liver functions and there were mainly serum alamin transaminase level elevations (87.29%) and serum albumin level reductions (74.55%).Of all the 305 cases,227cases (74.55%) in the stage of fever,295 cases (96.77%) in the stage of shock and 280 cases (91.95%) in the stage of oliguria appeared liver disfumcfion.Liver fumctions of most patients had recovered gradually with recovery of the disease.Causes of unrecovery of liver fumction in remainder patients was related with formerly infection of hepatitis B virus.the more the patients’condilions were severe,the more the liver disfnnctions were severe.Of liver tissues light microscopy extracted from 8 patients who were dead by liver biopsy and one postmortem autopsy revealed cloudy swell- ing,fatty degeratien and focal necrosis of livepr cells.These results show that hemorrhagic fever hepatitis exists generally in patients with EHF.