摘要
目的分析登革热肺部受累病例的临床特征,以提高对该病的认识。方法2014年7月-2018年10月中山大学附属第三医院收治的96例肺部受累登革热病例,其中重症登革热42例和普通登革热54例。对比分析其临床特点、实验室及影像学资料、治疗与预后。结果肺部受累病例中,重症登革热比例高达43.8%。重症登革热组高血压基础疾病者比例高于普通登革热组(38.1%vs.16.7%),差异有统计学意义(χ~2=5.57,P<0.05)。重症登革热组血小板(46.5×10~9/L)明显低于普通登革热组(55.5×10~9/L),而谷草转氨酶、谷丙转氨酶、肌酸激酶、肌酸激酶同工酶、乳酸脱氢酶、肌红蛋白(分别为96.0、54.0、355.0、9.0、336.0、101.0 U/L)均明显高于普通登革热组(分别为55.0、39.0、139.0、8.0、267.5、36.2 U/L),差异有统计学意义(P均<0.05)。登革热肺部损害影像表现为炎性渗出51例(53.1%),纹理增粗45例(46.9%),胸腔积液8例(8.3%),胸膜增厚4例(4.2%),间质性肺炎1例(1.0%)。肺部受累病例合并多器官功能损害,重症登革热组并发多器官功能衰竭7例,临床死亡1例。结论肺部受累登革热病例发生重症登革热几率高,对合并高血压、血小板明显降低、转氨酶及肌酶升高明显的肺部受累登革热病例应密切监测其进展至重症登革热的风险。
Objective To investigate and analyze the clinical characteristic of dengue with lung lesion.Methods Ninety six dengue patients admitted in the Third Affiliated Hospital of Sun Yat-sen University from July 2014 to October 2018 were enrolled.The clinical characteristic,detail of lung lesion,relationship with severe dengue,treatment and outcome of the patients were analyzed.Results 42 out of 96 dengue with lung lesion cases were severe dengue(SD),accounting for 43.8%.Hypertension rate(38.1%)was higher in SD than that in dengue(16.7%)(χ~2=5.57,P<0.05).Platelet in SD with 46.5×10~9/L was lower than 55.5×10~9/L in dengue,while AST,ALT,CK,CKMB,LDH,MGB were higher in SD(all P<0.05).The median numbers in SD were 96.0,54.0,355.0,9.0,336.0,and 101.0 U/L,respectively,compared with 55.0,39.0,139.0,8.0,267.5,and 36.2 U/L in dengue.The main lung lesion in imaging examination including interstitial effusion 51 cases(53.1%),increased lung marking 45 cases(46.9%),pleural effusion 8 cases(8.3%),pleura thickness 4 cases(4.2%)and interstial pneumonia 1 case(1.0%).Multi-organ injury could be involved in dengue with lung lesion;7 cases suffered multiple organ dysfunction syndrome in SD and 1 case died of multiple organ dysfunction syndrome.Conclusion Mobidity of SD was high in dengue with lung lesion.More attention should be paid on cases suffered hypertension,thrombocytopenia,increase of aminotransferase and creatase in dengue with lung lesion.
作者
师小函
石云锋
淦伟强
巴俊慧
罗进梅
王艳红
吴本权
SHI Xiao han;SHI Yun feng;GAN Wei qiang;BA Jun hui;LUO Jin mei;WANG Yan hong;WU Ben quan(Department of MICU,Department of Pulmonary and Critical Care Medcine,the Third Affiliated Hospital of Sun Yat sen University,Guangzhou,Guangdong 510630;Department of Infectious Diseases,the Third Affiliated Hospital of Sun Yat sen University,Guangzhou,Guangdong 510630,China)
出处
《热带医学杂志》
CAS
2019年第12期1527-1530,共4页
Journal of Tropical Medicine
作者简介
师小函(1992-),女,硕士,住院医师,主要从事重症医学及呼吸系统感染性疾病研究;通讯作者:吴本权,E mail:zswbq@163.com
