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目的分析登革热并发肝脏功能损害的临床表现及特征与血小板及白细胞的相关性。方法对2014年9~11月收治的823例登革热患者的临床资料进行回顾性分析。通过对登革热患者丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)、总胆红素(TB)及白细胞(WBC)、血小板(PLT)的检测,分析登革热并发肝脏功能受损害的情况及其与WBC、PLT的相关性。结果823例登革热患者中并发肝脏功能损害者共582例(70.7%),其中丙氨酸氨基转移酶(ALT)升高447例(占54.3%),门冬氨酸氨基转移酶(AST)升高554例(67.3%),而总胆红素(TB)升高仅66例(8%),血小板减少者602例(74.0%),白细胞减少者596例(73.3%)。儿童及中老年登革热患者合并肝脏功能损害的发生率较青少年患者要高。ALT、AST在病程的7~14 d高于病程的7d内及14 d后,差异有统计学意义,而TB在病程的7 d内升高明显,但与病程的7~14 d及14 d后相比较无明显差别。登革热患者血清中ALT、AST、TB的改变与同期静脉血中WBC、PLT改变无显著相关性。结论登革热患者并发肝脏功能损害是登革热病程中多系统器官功能损害中一个多发和常见的局部表现之一,其与年龄及病程有关,而与WBC及PLT无关。
Objective To analyze the clinical manifestations and characteristics of dengue fever complicated with hepatic dysfunction and its correlation with platelets and leucocytes. Methods The clinical data of 823 dengue fever patients admitted from September to November 2014 were analyzed retrospectively. Through the detection of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TB), white blood cell (WBC) and platelet (PLT) in dengue fever patients, Impairment and its relevance to WBC, PLT. Results A total of 582 patients (70.7%) with degeneration of liver function were found in 823 patients with dengue fever. Among them, ALT increased 447 (54.3%) and aspartate aminotransferase (67.3%), while only 66 cases (8%) of total bilirubin (TB) increased. There were 602 cases (74.0%) with thrombocytopenia and 596 cases (73.3%) with leukopenia. The incidence of liver dysfunction in children and middle-aged and elderly patients with dengue is higher than in adolescents. ALT, AST in the course of 7 ~ 14 d higher than the course of 7d and 14 d, the difference was statistically significant, and TB in the course of 7 d increased significantly, but with the course of 7 to 14 d and 14 d After no significant difference compared. The changes of serum ALT, AST and TB in dengue fever patients were not significantly correlated with the changes of WBC and PLT in the same period. Conclusions The dengue fever complicated with hepatic dysfunction is one of the most frequent and localized manifestations of multi-system organ dysfunction in dengue fever. It is related to age and course of disease, but not to WBC and PLT.