舟山海岛发热伴血小板减少综合征血常规生化特征动态分析  

Dynamic analysis on hematological and biochemical parameters in severe fever with thrombocytopenia syndrome in Zhoushan Achipelago

作　　者：鲍舟君[1] 姚燕珍[1] 张晓帮[1] 谢淑云[2] 李世波[3] 

机构地区：[1]舟山医院(温州医科大学附属舟山医院)检验中心,浙江舟山316004 [2]浙江省疾病预防控制中心 [3]温州医科大学附属舟山医院传染科

出　　处：《中国预防医学杂志》2014年第7期668-672,共5页Chinese Preventive Medicine

基　　金：浙江省医药卫生平台重点资助计划(2012ZDA044)

摘　　要：目的探讨舟山海岛地区发热伴血小板减少综合征(severe fever with thrombocytopenia syndrome,SFTS)患者的临床血常规、生化特征。方法采用血细胞分析仪及全自动生化仪分别检测2011年5月至2013年10月温州医科大学附属舟山医院收治的27例SFTS患者治疗前及治疗10d后血常规、血生化指标。用χ2检验或t检验分析血常规、血生化检测值的动态变化。结果 SFTS患者治疗前白细胞、中性粒细胞、淋巴细胞、血小板均明显低于正常体检者,差异有统计学意义(P<0.05)。治疗10d后白细胞、中性粒细胞、血小板均明显上升,与正常体检者比较差异无统计学意义。SFTS治疗痊愈者血小板明显高于死亡者,差异有统计学意义(P<0.05)。SFTS患者治疗前及治疗10d后丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转氨酶(AST)、乳酸脱氢酶(LDH)、肌酸激酶(CK)、肌酸激酶同功酶(CKMB)均高于正常参考值数倍,并较正常体检者高,差异有统计学意义(P<0.05),但尿素(Urea)、肌酐(Cr)均处于正常参考范围内。治疗10d后,AST、LDH、CK、CKMB高于正常参考值上限及高于正常参考值上限2倍的SFTS患者明显减少,差异有统计学意义(P<0.05);而SFTS患者ALT治疗前后差异无统计学意义。结论检测血常规及血生化指标对诊断及监测SFTS患者疾病进展情况具有非常显著的临床意义,并且需特别关注血小板及心肌酶谱的动态变化。Objective To analyze the dynamic changes of hematological and biochemical parameters in sever fe- ver with thrombocytopenia syndrome （SFTS） in Zhoushan Achipelago. Methods Hematological and bio- chemical parameters were measured by automated blood analyzer and automatic biochemical analyzer among pa- tients with SFTS in Zhoushan hospital ten days before and after treatment from May 2011 to October 2013. Chi square test and t test were used for data analysis. Results Before treatment, the counts of white blood cells （WBC）, neutrophils, lymphocytes and platelets were significantly lower in patients with SFTS compared to normal controls （P^0.05） . However, after ten days treatment, the number of above cells greatly increased and almost reached to normal level. The counts of platelets were significantly higher among patients recovered after treatment compared to those died （P〈0.05） . The serum levels of ALT, AST, LDH, CK, CKMB were all higher in patients both before and after treatment compared with normal controls （P〈0.05）, while the serum levels of Urea and Cr were in the normal range. After ten days treatment, the number of patients with AST, LDH, CK, CKMB levels higher or 2 times higher than the upper limit of norreal range decreased significantly （P〈0.05） . However, the serum level of ALT did not change a lot before and after treatment （P〉0.05）. Conclusions Monitoring the change of hematological and biochemical pa- rameters may help the diagnosis of SFTS as well as tracing the progression of disease, especially the dynamic change of platelets and myocardial enzymes.

关 键 词：发热伴血小板减少综合征 新布尼亚病毒 血常规 血生化 

分 类 号：R510[医药卫生—内科学]