重症登革热合并急性溶血性贫血和地中海贫血1例  

A case of severe dengue fever combined with acute hemolytic anemia and thalassemia

作　　者：何妍 何珺[2] 杨淑娟 HE Yan;HE Jun;YANG Shujuan(Department of Tuberculosis,Yunnan Provincial Hospital of Infectious Disease,Kunming,Yunnan 650106,China;Department of Leprosy Prevention and Control,Yunnan Center for Disease Control and Prevention,Kunming,Yunnan 650034,China;Department of Infectious Diseases,Xishuangbanna People's Hospital,Xishuangbanna,Yunnan 666100,China)

机构地区：[1]云南省传染病医院结核科,云南昆明650106 [2]云南省疾病预防控制中心麻风病防制所,云南昆明650034 [3]西双版纳州人民医院感染科,云南西双版纳666100

出　　处：《热带医学杂志》2025年第1期129-132,共4页Journal of Tropical Medicine

基　　金：云南省医疗卫生单位内设研究机构科研项目(2017NS099)。

摘　　要：目的分析重症登革热合并急性溶血性贫血、地中海贫血的临床特点及诊治策略。方法分析2023年8月1日西双版纳州人民医院收治的1例重症登革热合并急性溶血性贫血、地中海贫血的临床资料,并结合文献资料进行复习。结果重症登革热合并急性溶血性贫血、地中海贫血患者出现高热、严重乏力、腰背酸痛,上消化道出血、心肌炎、肝肾脏损害,血浆游离血红蛋白、血小板进行性下降;给予补液、输血、护胃、保肝、碳酸氢钠碱化尿液,改善肾功能及退热止痛治疗,症状好转。结论对于重症登革热合并急性溶血性贫血、地中海贫血病例,给予及时补液、输血等各项综合治疗措施,可达到良好的治疗效果。Objective To analyze the clinical characteristics,diagnosis and treatment strategies of severe dengue fever combined with acute hemolytic anemia and thalassemia.Methods The clinical data of one case of severe dengue fever complicated with acute hemolytic anemia and thalassemia admitted to Xishuangbanna People's Hospital on August 1,2023 was analyzed,and a literature review was performed.Results Patients with severe dengue fever combined with acute hemolytic anemia and thalassemia presented with high fever,severe malaise,low back pain,upper gastrointestinal bleeding,myocarditis,hepatic and renal damage,and progressive decline in plasma free hemoglobin and platelets.Administered with rehydration,blood transfusion,gastric protection,hepatoprotection and sodium bicarbonate to alkalize urine could improve renal function;antipyretic and analgesic treatment could relieve the symptoms.Conclusions For severe cases of dengue fever combined with acute hemolytic anemia and thalassemia,timely fluid replacement,blood transfusion and other comprehensive treatment measures could achieve good therapeutic effects.

关 键 词：登革热 重症登革热 溶血性贫血 地中海贫血 

分 类 号：R512.8[医药卫生—内科学]