Clinical Characteristics And Strategy On Hemorrhagic Fever With Renal Syndrome For Last Decade

Objective This thesis analyzed the epidemiology and clinical characteristics of hemorrhagic fever with renal syndrome, compared its clinical characteristics variation with that decade ago, and provided basis for its clinical diagnosis and treatment.Material and method1. Study object: Ninety-nine HFRS patients in Infectious Disease,the First Hospital of Jinlin University, are divided into A group and B group in according to clinic time. A group includes 71 people(clinic time: from Nov. to Dec, 2005) and B group includes 28 people(clinic time: from Nov. to Dec, 2015). Diagnosis fits for Epidemic Hemorrhagic Fever Diagnostic Criteria(WS278-2008) issued by the Ministry of Public Health in 2008.2.Summarize the epidemiology data, clinic characteristics and blood biochemical test of the two groups, and analyze and compare the epidemiology data, clinic characteristics and blood biochemical test differences between two groups.3.Statistical analysis: use SPSS 22 software, use chi-square test to for enumeration data, adopt t-test for measurement data, take p<0.05 as obvious statistic difference.Result1. epidemiology characteristics: the patient quantity is obviously reduced in 2015 compared to those in the same months in 2005; elder patients number increase, most of which are farmers. The number is small in former epidemic area, and increases in new epidemic area.There is no obvious difference among gender rate.2. main clinical manifestation: patients clinical data in 2015 and2005: fever degree is reduced, and the number of patients whose temperature over 40℃ obviously reduces(15.9%—10.7%). During the course of disease, the rate of oliguria patients reduces from 21.1% to10.7%. The rate of hypotension and shock patients reduces from 43.7%to 17.9%. The rate of patients with percussion pain in liver and kidney also sharply reduces. There are 6 patients with consciousness disturbance in A group, but none in B group.3. laboratory inspection: the increasing rate of leucocyte reduces from 54.9% to 35.7%, and the rate of leucocyte number( ≥20×109/L)reduces 14.1% to 10.7%. The rate of thrombocytopenia increases from78.9% to 85.7% in B group, and the rate of blood platelet number(≤30×109/L) reduces from 23.9% to 10.7%. Thrombocytopenia is more general, but the serious thrombocytopenia is rare.The rates of raising AST is quite equal in two groups(85.9% in A group and 85.7% in B group), but the rate(≥500U/L) reduces from15.5% to 3.6%. The rate of raising ALT reduces from 81.7% to 75.0% in B group, and the patient rate(≥20mmol/L) reduces from 21.1% to14.3%. The rate of patients with creatinine(≥500umol/L) reduces from15.5% to 7.1%.Compared the AST and ALT result in two groups by t-test, there is statistics difference(P<0.05).4.Prognosis: complication in A group obviously reduces, so as the fatality rate.Conclusion1. The elder HFRS patient’s rate increases in the last decade.2. The HFRS case lacking typical clinical manifestation increases in the last decade, but the clinical symptoms is not serious.3. In Jilin Province, morbidity in former epidemic area reduces but increases in new epidemic area in the last decade.4. The fatality rate dramatically declines, and the prognosis is better in the last decade.