Avdeeva M G
Klin Med (Mosk). 2003;81(6):42-7.
To elucidate the time of onset and duration of complications of icterohemorrhagic leptospirosis (IL), a clinical course of early and late convalescence was analysed in 170 patients who were followed up for 1.5-9 years. It was found that affection of hepatobiliary, urinary, cardiovascular and nervous systems persisted for a year after the acute disease in 65.3, 67.6, 31.8 and 13.5% patients, respectively. The organ of vision was affected for 1 year in 7.1% patients. A total of 86% patients retained the above disorders in early convalescence (for a year). In early convalescence the author observed development of such diseases as chronic hepatitis, a latent stage of chronic renal failure, myocardiac myocardiodystrophy. Nervous and ocular complications manifested both in early and late convalescence (4-18 months). The complications combined in 66.0% cases, renal dysfunction + hepatic dysfunction being most frequent. Endogenic infection foci activated within 6 months after IL. In 19.4% patients, the pathological process prolonged up to 1.5 years. In 5.3% patients it can last for several years. It is concluded that IL patients should be followed up for 1.5 years, combined pattern of organ affection typical for IL should be taken into account.
为阐明黄疸出血型钩端螺旋体病（IL）并发症的发病时间及持续时间，对170例随访1.5至9年的患者的早、晚期恢复期临床病程进行了分析。结果发现，分别有65.3%、67.6%、31.8%和13.5%的患者，其肝胆、泌尿、心血管和神经系统的病变在急性病后持续了一年。7.1%的患者眼部器官病变持续了1年。共有86%的患者在恢复期早期（长达1年）仍存在上述病症。在恢复期早期，作者观察到了慢性肝炎、慢性肾衰竭潜伏期、心肌心肌营养不良等疾病的发生。神经和眼部并发症在恢复期早期和晚期（4至18个月）均有表现。并发症在66.0%的病例中合并出现，肾功能不全+肝功能不全最为常见。IL发病后6个月内，内源性感染灶被激活。19.4%的患者病理过程延长至1.5年。5.3%的患者病理过程可持续数年。结论是，应对IL患者随访1.5年，应考虑到IL典型的器官受累联合模式。
