云南景洪登革病毒感染合并肝损害病例临床特征分析  

Clinical characteristics of dengue virus infection combined with liver function damage in Jinghong city,Yunnan province

作　　者：李杨思琪 李曼 贾文爽 周勇 陈邑洪 余兰 杨斌 周红宁[2] LIYANG Si-qi;LI Man;JIA Wen-shuang;ZHOU Yong;CHEN Yi-hong;YU Lan;YANG Bing;ZHOU Hong-ning(School of Public Health,Kunming Medical University,Kunming,Yunnan 650500;Yunnan Provincial Key Laboratory of Vector-Borne Disease Control and Research,Yunnan Innovative Team of Key Techniques for Vector-Borne Disease Control and Prevention,Yunnan Institute of Parasitic Disease,Pu'er,Yunnan 665000;College of Basic Medicine,Dali University,Dali,Yunnan 671000;The Infectious Hospital of Xishuangbanna,Jinghong,Yunnan 666100;The People's Hospital of Dai Nationality Xishuangbanna,Jinghong,Yunnan 666100,China)

机构地区：[1]昆明医科大学公共卫生学院,云南昆明650500 [2]云南省虫媒传染病防控研究重点实验室,云南省寄生虫病防治所虫媒传染病防控关键技术创新团队(培育),云南省寄生虫病防治所,云南普洱665000 [3]大理大学基础医学院,云南大理671000 [4]西双版纳传染病医院,云南景洪666100 [5]西双版纳傣族自治州人民医院,云南景洪666100

出　　处：《热带医学杂志》2021年第2期140-143,共4页Journal of Tropical Medicine

基　　金：国家自然科学基金(U1602223);国家重大专项项目(2018ZX10101004-003-001);云南省科技重大专项(2017ZF007)。

摘　　要：目的探讨云南景洪市登革热患者并发肝损害病例临床特征,为当地医疗机构制定有效登革热诊疗方案提供依据。方法对景洪市2017-2018年登革热病例基本流行病学特征、临床症状及实验室生化指标进行回顾性分析。结果812例登革热患者中,合并肝损害486例,并以天门冬氨酸氨基转移酶(54.3%,441/812例)和丙氨酸氨基转移酶(40.8%,331/812例),升高为主;与非合并肝损害326例患者相比,合并肝损害患者在男性(51.6%,251/486)、高龄(41.46±17.10)岁、血小板降低(52.9%,257/486)、乳酸脱氢酶升高(68.0%,330/486)、肌酸激酶升高(37.9%,184/486)等方面差异有统计学意义(χ_(性别)^(2)=18.786,t年龄=4.441,χ_(血小板降低)^(2)=54.827,χ_(乳酸脱氢酶升高)^(2)=208.827,χ_(肌酸激酶升高)^(2)=67.442;P均<0.05)。结论登革热病例中男性、年龄较大的患者更容易出现肝损害。出现肝损害的登革热病例中血小板降低、乳酸脱氢酶和磷酸肌酸激酶升高比例较高,且其重症化趋势也较为明显。Objective To discuss the clinical features of dengue fever(DF)with liver function damage patients in Jinghong city,Yunnan province,providing evidences to make out effective diagnosis and treatment measurements for dengue fever patient for local hospital.MethodThe characteristics of the basic epidemiology,clinical symptoms and laboratorial biochemical indicators were analyzed by the retrospective method for dengue fever patients in Jinghong city from 2017 to 2018.Results Among the 812 DF patients,486 cases with liver damages showing the predominant rising of the aspartate aminotransferase(54.3%,441/812 cases)and alanine aminotransferase(40.8%,331/812 cases).Compared with 326 patients without liver damages,there were significant differences between the former dengue fever with liver damages and the latter those without liver damages on male(51.6%,251/486),elderly(41.46±17.10)year,platelet decreasing(52.9%,257/486)and the rising of lactate dehydrogenase(68.0%,330/486)and creatine kinase(37.9%,184/486)(χ_(gender)^(2)=18.786,tage=4.441,χ_(platelet decreasing)^(2)=54.827,χ_(lactate dehydrogenase rising)^(2)=208.827,χ_(creatine kinase rising)^(2)=67.442;P<0.05).Conclusions Among the dengue fever cases,males and older patients were more likely to have liver damage.In dengue fever cases with liver damage,the proportion of platelet decrease,lactate dehydrogenase and creatine phosphate kinase increase,and its tendency to become severe was also obvious.

关 键 词：登革热 肝损害 临床特征 

分 类 号：R512.8[医药卫生—内科学]