Analysis On The Clinical Manifestations Of 136 Hemorrhagic Fever With Renal Syndrome In Zhuhai City During 2007～2016

Objective: Collecting the clinical manifestations and relevant auxiliary examnination information of 136 Hemorrhagic fever with renal syndrome(HFRS)patients in Zhuhai City during 2007-2016 and analyzing its Clinical features,which will help provide scientific basis for the control,prevention and treatment of the disease in this region.Methods: The clinical features of 136 patients with HFRS in Zhuhai City during 2007-2016 will be investigated and analysized retrospectively.all cases were cinfirmed by Anti-HFRS-Ig M(+)through the centers for disease control(CDC).Results: 1.The general situation:Collect totally 136 patients,including 38 patients w-ith clear rats exposure history,the rest of patients are unknown.The outbreak is mainly distributed,especially in doumen district,the peak period is in Spring and Winter festival,most were located in the group aged from 30 to 60,and male and female ratio is 3.5 to 1.The career of the patients mainly distributed in workers and farmers,respectively for 30.88% and 16.91%.2.The result of clinical feature:the analysis results of clinical manifestation show that the clinical characteristics mainly focus on fever(136 cases,100%),anorexia(94 cases,69.1%),fatigue(90 cases,66.2%),nausea(75 cases,55.1%),vomiting(56 cases,41.2%),headache(61 cases,44.9%),osphyalgia(60 cases,44.1%);accompanied by limbs arthralgia(45 cases,33.1%),facial flush(37 cases,27.2%),nech red(40 cases,29.4%),the flush on the chest(31 cases,22.8%),diarrhea(40 cases,29.4%),eye pain(11 cases,8.1%).among of those three red symptoms(facial flush,nech red,the flush on the chest)(21 cases,15.4%),three pain symptoms(headache,osphyalgia,eye pain)(6 cases,6.6%).physical check:body temperature:low-grade fever(37.3~38℃),(5 cases,3.7%);Moderate fever(38.1~39℃)(54 cases,39.7%),High fever(39.1~40℃)(56 cases,41.2%),Super high fever(>41℃)(0 cases,0%),Swallow red(71 cases,52.2 %),The soft palate,armpits,back,chest and abdomen haemorrhage(46 cases,33.8 %),Abdominal tenderness and bounce pain(99 cases,72.8%),Renal area knocking pain(33 cases,24.3%),Liver and spleen enlargement(8 cases,5.9%).3.Laboratory and its related auxiliary examination results:(1)Routine blood:white blood cell(WBC)elevates in 71 cases(52.25),the highest: 32.1×109/L;and platelet(PLT)reduces in 117 cases(87.5%),the lowest: 1×109/L(2)renal funct-ion:136 cases with routine renal function test,including urea nitr-ogen(BUN)inc-reases in 75 cases(57.3%)and creatinine(Cr)increases in 88 cases(65.2%)(3)136 cases of patients,except 7 cases without liver result examination and 5 patients with fatty liver,hepatitis,glutamine acid propyl transfer enzyme(ALT)increases in 112 cases(90.32%),and aspartate aminotransferase(AST)in 114 cases(91.94%),total bilirubin(TBIL)increases in 36 cases(26.61%),albumin(ALB)decreases in 122 cases(98.40%)(4)Blood coagulation function:111 of 136 cases with routine coagulation function test,including prothrombin ratio(PT)extensions in 40 cases(36.0%)and activated partial thromboplastin time(APTT)extensions in 62 cases(56.4%)(5)Feces regular:136 cases with routine feces examination,Positive fecal occult blood test(±~++)has 40 cases(29.4%)(6)Urine routine inspection: 136 cases with routine routine inspection,the examination shows that Urinary protein was 83,among of them ±(6 cases,7.2%),+(16 cases,19.3%),2+(27 cases 32.5%),3+(26 c-ases 31.3%),4+(8 cases,9.6%)(7)Chest computed tomography:30 of 136 patients with routine Chest computed tomography examination,Pulmonary inflammatory exudation(18cases 60.0%)(8)Ecg examination: 80 of 136 patients with Ecg examination,Sinus rhythm(60 cases,75.0%),Sinus bradycardia(15 cases,18.8%),I and II degree atrioventricular block(2 cases,2.5%),Atrial fibrillation(2 cases,2.5%),Frequent ventricular premature beat(1 cases 1.3%)(9)Abdominal ultrasound:102 of 136 patients with Abdominal ultrasound examination,Abdominal ultrasound(4 cases,3.9%),Abdominal cavity effusion(7 cases,6.9%),Echogenicity of renal parenchyma(9 cases,8.8%),Acute nephritis signs(2 cases,2.0%),Bilateral renal enlargement(2 cases,2.0%).Conclusion:(1)The peak incidence of 136 HFRS in Zhuhai was mainly belonging to Sping and winter during 2007-2016,Onset age primarily focused on 30 ~ 60 and men were more than women obviously.(2)The clinical symptoms of 136 HFRS patients were light and atypical in Zhuhai,2007-2016 and were easily to misdiagnosis,patients in the affected area should be alert to HFRS when they have fever and thrombocytopenia,and at the same time we shoud detect the blood heat antibody in time,and through the research we found that most of patients recover well after treatmen.