【摘要】：目的:研究腎綜合征出血熱（Hemorrhagic fever with renal syndrome，HFRS）患者不同時期胰腺功能水平（血清淀粉酶、血清脂肪酶）的動態(tài)變化及該變化與病情嚴(yán)重程度之間的關(guān)系。進(jìn)而提示臨床應(yīng)重視HFRS的胰腺損害。 方法:我院2010年到2013年收入院治療的腎綜合征出血熱患者共22例，采取回顧性分析方法收集資料，比較患者的胰腺功能指標(biāo)血清淀粉酶（Amy）、血清脂肪酶（Lip），在該病程的發(fā)熱期、低血壓休克期、少尿期、多尿期、恢復(fù)期之間的差異及與10例健康對照者之間的差異；比較上述兩項指標(biāo)在輕型、中型、重型和危重型患者中的表達(dá)水平與10例健康對照者中的表達(dá)水平的差異。 結(jié)果：1.統(tǒng)計分析顯示：無胰腺功能受損的HFRS患者的住院天數(shù)（13.25±3.99天），有胰腺功能受損的HFRS患者的住院天數(shù)（30.29±16.26天），二者比較，差異有統(tǒng)計學(xué)意義（P0.05）。2.22例HFRS患者中共有14例（63.64%）胰腺功能損害呈現(xiàn)陽性結(jié)果，其中輕型組入組有三例，中型組入組有四例，重型組入組有三例，危重型組入組有四例。3.與健康對照組胰腺功能指標(biāo)相比較，各種分型的腎綜合征出血熱患者對應(yīng)的相關(guān)指標(biāo)水平明顯高于前者，即（P0.05），且隨病情嚴(yán)重程度遞增。血清中Amy、Lip濃度由低到高依次為輕型（92.99±8.56U/L，85.06±8.17mmol/L）、中型患者（248.41±16.89U/L，205.98±9.72mmol/L）、重型患者（251.63±23.10U/L，223.63±5.42mmol/L）、危重型患者（253.10±13.49U/L，349.86±28.70mmol/L），各型之間均有顯著性差異（P0.05）。4.與健康對照組胰腺功能指標(biāo)相比較，可見各個時期的腎綜合征出血熱患者對應(yīng)的相關(guān)指標(biāo)水平明顯高于前者，即（P0.05）。血清中Amy、Lip濃度由低到高依次為少尿期（316.22±52.24U/L，408.89±47.25mmol/L）、低血壓休克期（222.26±18.90U/L，305.14±79.71mmol/L）、多尿期（205.75±30.79U/L，243.86±63.97mmol/L）、恢復(fù)期（121.32±22.72U/L，131.78±40.06mmol/L）、發(fā)熱期（105.55±10.30U/L，，94.11±14.41mmol/L），其中發(fā)熱期與低血壓休克期、少尿期與多尿期、多尿期與恢復(fù)期相比均有統(tǒng)計學(xué)差異（P0.05）。 結(jié)論:HFRS對于胰腺功能可以造成損害。HFRS患者胰腺功能指標(biāo)與患者病情嚴(yán)重密切相關(guān)，可作為判斷HFRS的分期及嚴(yán)重程度的參考指標(biāo)，故檢測胰腺功能對判斷HFRS的分期及嚴(yán)重程度、指導(dǎo)治療、判斷預(yù)后具有重要的臨床參考價值。
[Abstract]:Objective: to study the dynamic changes of pancreatic function (serum amylase, serum lipase) in patients with hemorrhagic fever with renal syndrome (Hemorrhagic fever with renal syndrome,HFRS) at different stages and the relationship between the changes and the severity of the disease. It is suggested that the pancreatic damage of HFRS should be paid more attention to in clinic. Methods: from 2010 to 2013, 22 patients with hemorrhagic fever with renal syndrome were treated in our hospital from 2010 to 2013. The data were collected by retrospective analysis, and the serum amylase (Amy), serum lipase (Lip), was compared in the fever stage of the disease course. The differences between hypotension shock, oliguria, polyuria, convalescence and 10 healthy controls were compared. The expression levels in severe and critical patients were different from those in 10 healthy controls. The result is 1: 1. Statistical analysis showed that the hospitalization days of HFRS patients without pancreatic function impairment (13.25 鹵3.99 days) and HFRS patients with pancreatic dysfunction (30.29 鹵16.26 days) were compared. The difference was statistically significant (P0.05) .2.22 cases of HFRS patients, 14 cases (63.64%) showed positive results of pancreatic function damage, of which there were 3 cases in mild group, 4 cases in medium group, 3 cases in severe group and 4 cases in critical type group. Compared with the normal control group, the relative indexes of the patients with hemorrhagic fever with renal syndrome were significantly higher than those of the former (P0.05), and increased with the severity of the disease. The levels of Amy,Lip in serum from low to high were mild (92.99 鹵8.56U / L), moderate patients (248.41 鹵16.89U / L, 205.98 鹵9.72mmol/L), severe patients (251.63 鹵23.10U / L, 223.63 鹵5.42mmol/L), critical type patients (253.10 鹵13.49U / L 349.86 鹵28.70mmol/L). Compared with the normal control group, the corresponding indexes of hemorrhagic fever with renal syndrome in each stage were significantly higher than those of the former (P0.05). 琛

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