Puljiz Ivan, Kuzman Ilija, Turcinov Drago, Makek Nikola, Markotić Alemka
Klinika za infektivne bolesti, Dr. Fran Mihaljević , Zagreb, Croatia.
Acta Med Croatica. 2005;59(2):105-11.
To examine the frequency and distribution of hematologic and biochemical laboratory findings in 94 patients with hemorrhagic fever with renal syndrome (HFRS) in the epidemic year 2002.
The following laboratory findings were retrospectively analyzed: erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), hemoglobin, hematocrit, leukocyte count and differential percentage (segmented neutrophils, band neutrophils, atypical lymphocytes), platelet count, coagulation tests, blood urea nitrogen (BUN), creatinine, urine, potassium, bilirubin (BIL), aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyltransferase (GT), alkaline phosphatase (ALP), and serum protein electrophoresis. The study included 94 HFRS patients treated at the Dr Fran Mihaljević University Hospital for Infectious Diseases in Zagreb during 2002.
ESR increase, mostly mild to moderate, was found in 86.2% of study patients. Increased CRP was recorded in 98.9% of study patients, however, one-fourth had CRP higher than 100 mg/L. Leukocytosis was recorded in 38.3% (10.1 +/- 4.2 x 10(9)/L), thrombocytopenia in 89.4% patients (68.2 +/- 48.3 x 10(9)/L), and severe thrombocytopenia (x 10(9)/L) in six patients. Three patients had abnormal coagulation tests. Increased values of BUN and creatinine were recorded in more than a half of patients, while only four patients had mild hyperkalemia. Only three patinets required hemodialysis. Mildly to moderately increased values of aminotransferases (AST, ALT, GT) were observed in more than 2/3; hypoalbuminaemia in nearly 1/3, and elevated alpha-2 fraction in more than 2/3 of patients. The majority of patients had pathologic urine findings. First laboratory abnormalities were usually found between day 5 and 7 of the disease (increased CRP level, thrombocytopenia, leukocytosis, and elevation of hemoglobin and hematocrit). Biochemical abnormalities(elevation of cratinine and urea, increased levels of aminotransferases) usually occurred at the beginning of the second week, and ESR increase in the second week of disease.
The majority of our patients had laboratory findings characteristic of HFRS. Thrombocytopenia and increased level of CRP were the most common laboratory findings during the first week of the disease. Renal and liver impairment occurred at the beginning of the second week of the disease.
研究2002年流行性出血热（HFRS）流行期间94例HFRS患者血液学和生化检查结果的频率及分布情况。
对以下实验室检查结果进行回顾性分析：红细胞沉降率（ESR）、C反应蛋白（CRP）、血红蛋白、血细胞比容、白细胞计数及分类百分比（分叶中性粒细胞、杆状中性粒细胞、异型淋巴细胞）、血小板计数、凝血试验、血尿素氮（BUN）、肌酐、尿液、钾、胆红素（BIL）、天冬氨酸转氨酶（AST）、丙氨酸转氨酶（ALT）、γ-谷氨酰转移酶（GT）、碱性磷酸酶（ALP）以及血清蛋白电泳。研究纳入2002年在萨格勒布市弗兰·米哈列维奇大学传染病医院接受治疗的94例HFRS患者。
86.2%的研究患者ESR升高，多数为轻度至中度。98.9%的研究患者CRP升高，然而，四分之一患者的CRP高于100mg/L。38.3%（10.1±4.2×10⁹/L）的患者出现白细胞增多，89.4%的患者出现血小板减少（68.2±48.3×10⁹/L），6例患者出现严重血小板减少（×10⁹/L）。3例患者凝血试验异常。超过半数患者BUN和肌酐值升高，仅有4例患者出现轻度高钾血症。仅3例患者需要血液透析。超过2/3的患者转氨酶（AST、ALT、GT）轻度至中度升高；近1/3的患者出现低白蛋白血症，超过2/3的患者α-2球蛋白升高。多数患者尿液检查结果异常。最初的实验室异常通常出现在疾病第5至7天（CRP水平升高、血小板减少、白细胞增多以及血红蛋白和血细胞比容升高）。生化异常（肌酐和尿素升高、转氨酶水平升高）通常在第二周初出现，疾病第二周ESR升高。
多数患者具有HFRS的实验室特征。血小板减少和CRP水平升高是疾病第一周最常见的实验室表现。肾脏和肝脏损害在疾病第二周初出现。
