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目的分析肾综合征出血热(HFRS)患者临床出现重型病情恶化的相关因素。方法收集2011—2014年在台州医院住院治疗的151例HFRS患者资料,采用多因素Logistic回归分析影响HFRS患者病情恶化的相关因素。结果 151例HFRS患者男女比为2.43∶1,其中重型25例,占16.56%。血小板(PLT)<100×109/L、尿蛋白阳性、皮肤充血体征、谷丙转氨酶(ALT)>50 U/L和肌酐(Cr)>133μmol/L的HFRS患者分别占83.44%、81.46%、70.20%、68.21%和50.99%。多因素Logistic回归分析结果显示,年龄>60岁(OR=3.27,95%CI:1.03~10.43)、有出血体征(OR=6.41,95%CI:1.65~24.39)、尿隐血阳性(OR=2.06,95%CI:1.25~3.39)、PLT<30×109/L(OR=3.71,95%CI:1.18~11.62)和ALT>500 U/L(OR=17.59,95%CI:1.51~205.02)是患重型HFRS的危险因素(P<0.05)。结论 HFRS患者多存在PLT<100×109/L、尿蛋白阳性、皮肤充血体征、ALT>50 U/L和Cr>133μmol/L;年龄>60岁、有出血体征、尿隐血阳性、PLT<30×109/L和ALT>500 U/L可能为HFRS出现重型的危险因素。
Objective To analyze the related factors of severe clinical deterioration in patients with hemorrhagic fever with renal syndrome (HFRS). Methods The data of 151 HFRS patients hospitalized in Taizhou Hospital from 2011 to 2014 were collected. Multivariate Logistic regression analysis was used to analyze the factors that affected the worsening of HFRS patients. Results 151 patients with HFRS male to female ratio was 2.43: 1, of which 25 cases of heavy, accounting for 16.56%. HFRS patients with platelet (PLT) <100 × 109 / L, urine protein positive, signs of skin congestion, ALT> 50 U / L and creatinine> 133 μmol / L accounted for 83.44% and 81.46% 70.20%, 68.21% and 50.99%. Multivariate Logistic regression analysis showed that hemorrhagic signs (OR = 6.41, 95% CI: 1.65-24.39) and occult urine were positive (OR = 2.06 (OR = 3.71, 95% CI: 1.18-11.62) and ALT> 500 U / L (OR = 17.59, 95% CI: 1.51-205.02) Is a risk factor for severe HFRS (P <0.05). Conclusions Patients with HFRS mostly had PLT <100 × 109 / L, urinary protein positive, signs of skin congestion, ALT> 50 U / L and Cr> 133μmol / L; × 109 / L and ALT> 500 U / L may be heavy risk factors for HFRS.