论文部分内容阅读
目的:分析肾综合征出血热（HFRS）患者EB病毒（EBV）活动情况及其临床特征。方法:对2016年1月至2017年8月在哈尔滨医科大学附属第一医院住院的常规进行EBV血清学检测的确诊HFRS患者，根据其有无合并EBV感染分为2组，即EBV活动组和无EBV活动组。采用SPSS 18.0软件对两组间临床数据进行对比分析。结果:共纳入188例HFRS患者，其中EBV活动组73例，无EBV活动组115例，HFRS患者EBV活动率为38.83%（73/188）。EBV活动组患者出现腰痛、腹痛、皮肤黏膜充血及球结膜水肿的比例[57.53%（42/73）、42.47%（31/73）、57.53%（42/73）、50.68%（37/73）]显著高于无EBV活动组[42.61%（49/115）、20.00%（23/115）、39.13%（45/115）、28.70%（33/115）]，差异均有统计学意义（χn 2 = 3.983、11.008、6.083、9.239，n P均< 0.05）。EBV活动组病程中发生急性肾损伤（AKI）1期、2期和3期者分别为10、7和43例，无EBV活动组分别为5、13和53例。EBV活动组AKI程度重于无EBV活动组，差异有统计学意义（χn 2 = 12.615，n P < 0.05）。且EBV活动组肾功能恢复超过15 d者比例[23.29%（17/73）]、白细胞计数[11.26（3.39 ~ 54.23）× 10 n 9个/L]显著高于无EBV活动组[6.96%（8/115）、10.03（2.91 ~ 66.99）× 10n 9个/L]，差异均有统计学意义（χn 2 = 10.330，n Z = - 2.003，n P均< 0.05）。n 结论:HFRS患者可能使体内潜伏EBV活动，使其临床特征复杂化，肾功损伤程度重且肾功恢复时间延长。“,”Objective:To study the n Epstein-Barr virus (EBV) activity and its clinical characteristics in patients with hemorrhagic fever with renal syndrome (HFRS).n Methods:From January 2016 to August 2017, patients with HFRS who were hospitalized in the First Affiliated Hospital of Harbin Medical University were routinely tested by EBV serology, and were divided into two groups according to their presence or absence of EBV infection, namely EBV active group and non-EBV active group. The clinical data between the two groups were compared and analyzed by SPSS 18.0.Results:A total of 188 HFRS patients were enrolled, including 73 cases in EBV active group and 115 cases in non-EBV active group. The EBV active rate of HFRS patients was 38.83% (73/188). The incidences of lumbago [57.53% (42/73) n vs 42.61% (49/115)], abdominal pain [42.47% (31/73) n vs 20.00% (23/115)], skin and mucosa congestion [57.53% (42/73) n vs 39.13% (45/115)], and conjunctiva edema [50.68% (37/73) n vs 28.70% (33/115)] in EBV active group were significantly higher than those in non-EBV active group (χn 2 = 3.983, 11.008, 6.083, 9.239, n P < 0.05). There were 10, 7 and 43 patients with acute kidney injury (AKI) stage 1, 2 and 3 in EBV active group and 5, 13 and 53 patients in non-EBV active group. Degree of AKI in EBV active group was higher than that in non-EBV active group, and the difference was statistically significant (χ n 2 = 12.615, n P < 0.05). In EBV active group, the proportion of patients whose renal function recovery over 15 days [23.29% (17/73)] and white blood cell count [11.26 (3.39 ~ 54.23) × 10 n 9/L] were significantly higher than those in non-EBV active group [6.96% (8/115), 10.03 (2.91 ~ 66.99) × 10n 9/L], and the differences were statistically significant (χn 2 = 10.330, n Z = - 2.003, n P < 0.05).n Conclusion:HFRS patients may cause latent EBV activity, complicate their clinical features, cause severe renal damage and prolong the recovery time of renal function.