哈尔滨地区肾综合征出血热患者临床特征及感染的汉坦病毒血清型分析

目的研究哈尔滨地区肾综合征出血热患者的流行病学、临床特征及感染的汉坦病毒的血清型。方法对哈尔滨地区87例肾综合征出血热患者的流行病学资料、临床表现、实验室检查、转归等进行回顾性分析,并对发病5 d内患者感染的汉坦病毒血清型进行分析。结果87例患者中74.7%为农民.14.9%为林业工人.6.9%为学生、干部职员,3.4%为居民;农村56例,林区13例,郊区9例,城市9例。临床表现发热87例(100%),头痛44例(50.6%),腰痛35例(40.2%),眼眶痛17例(19.5%),恶心呕吐79例(90.8%),皮下出血点、淤斑29例(33.3%),少尿52例(59.8%),黑便35例(40.2%),腹痛26例(29.9%),腹胀61例(70.1%),抽搐2例(2.3%),呼吸困难4例(4.6%),三红征40例(46.0%),肾区叩痛52例(59.7%),球结膜水肿47例(54.0%)。实验室检查肝功能异常70例(80.5%);心肌酶学升高80例(92.0%);血糖异常53例(60.7%)。患者感染的汉坦病毒血清型,汉滩病毒占34.8%,汉城病毒占65.2%。结论哈尔滨地区肾综合征出血热的流行病学和临床特征的改变可能与汉坦病毒血清型的变化有关。

Analysis of clinical features and serotype of patients with hemorrhagic fever with renal syndrome in Harbin

Objective To study the features of epidemiological and clinical and serotypes of patients with hemorrhagic fever with renal syndrome (HFRS) in Harbin.Methods The epidemiological,clinical and laboratory data of patients with HFRS in our hospital were retrospectively analyzed.The serotypes of patients having an onset within 5 days were enrolled.Results Of 87 patients,74.7% were peasants,14.9% were forestry workers,6.9% were students and officrers and 3.4% were inhabitants;as for the origin,56 were from farms,13 from forest regions, 9 from suburb,9 from city.The most common manifestations were fever(100%),headache(50.6%),lumbodynia (40.2%),fossa orbitalis pain (19.5%),nausea and vomiting (90.8%),spots of subcutaneous hemorrhage (33.3%), oliguria (59.8%),melena (40.2%),abdominal pain (29.9%),abdominal distention (70.1%),hyperspasmia (2.3%), dyspnea(4.6%),three-red sign(46.0%),sensitive to percussion of renal region (59.7%),bulbar conjunctiva edema (54.0%).92 percent of patients were accompanied with change of a cardiac muscle enzymology,80.5% with liver dysfunction and 60.7% with pathoglycemia.The serotypes of patients were Hantaan virus (34.8%) and Seroul virus (65.2%).Conclusion The changes in epidemiological and clinical feature of patients with HFRS in Harbin may be related with virus migration.