36例新布尼亚病毒感染致发热伴血小板减少综合征血清生化酶谱聚类分析
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摘要
目的对36例新布尼亚患者血清生化酶谱进行聚类并分析其类别差异。方法选取2014年1月-2017年10月在本院及舟山医院门诊和住院确诊为新布尼亚病毒感染致发热伴血小板减少综合征的患者36例,全自动生化仪检测谷丙转苷酶(ALT)、谷草转氨酶(AST)、碱性磷酸酶(ALP)、γ-谷氨酰转肽酶(GGT)、乳酸脱氢酶(LDH)、肌酸激酶(CK)、酸性磷酸酶(ACP),并采集患者临床症状,采用K-Means法进行聚类分析。结果K-Means聚类法分类最终分为3类:A类有16例,以AST高水平、LDH高水平、CK的高水平为主要特征(AST~(high)/LDH~(high)/CK~(high)),B类有6例,以AST高水平、LDH低水平、CK低水平为主要特征(AST~(high)/LDH~(low)/CK~(low)),C类有14例,以ALT高水平、LDH中等水平、CK中等水平为主要特征(ALT~(high)/LDH~(medium)/CK~(medium))。A类患者的腹痛发生率(31.25%)高于B类(0%)和C类(7.14%),差异有统计学意义(χ~2=7.258,P<0.05)。A类的腹泻发生率(68.75%)高于B类(16.67%)和C类(28.57%),差异有统计学意义(χ~2=7.132,P<0.05)。结论对AST~(high)/LDH~(high)/CK~(high)新布尼亚病毒感染患者需要对消化道症状进行重点关注。
Objective To execute clusters of biochemical enzyme spectrum in patients with bunyavirus infection.Methods Thirtysix patients with fever with thrombocytopenia syndrome caused by Bunyavirus infection from January 2014 to October 2017 were selected from our hospital and Zhoushan Hospital.Automated biochemical analyzer was adopted for the detection of alanine transferase(ALT),aspartate aminotransferase(AST),alkaline phosphatase(ALP),γ-glutamyltranspeptidase(GGT),lactate dehydrogenase(LDH),creatine Kinase(CK)and acid phosphatase(ACP).Clinical symptoms were collected for cluster analysis by K-Means method.ResultsAccording to clustering analysis,there were 16 cases in group A(AST~(high)/LDH~(high)/CK~(high)),6 cases in group B(AST~(high)/LDH~(low)/CK~(low)),14 cases in group C(ALT~(high)/LDH~(medium)/CK~(medium)).Rate of abdominal pain in group A(31.25%)was significantly higher than group B(0%)and group C(7.14%),with the differences statistically significant(χ~2=7.258,P<0.05).Rate of diarrhea in group A(68.75%)was significantly higher than group B(16.67%)and group C(28.57%),with the differences statistically significant(χ~2=7.132,P<0.05).ConclusionMore attention should be paid to digestive tract symptom in patients with AST~(high)/LDH~(high)/CK~(high).
Objective To execute clusters of biochemical enzyme spectrum in patients with bunyavirus infection.Methods Thirtysix patients with fever with thrombocytopenia syndrome caused by Bunyavirus infection from January 2014 to October 2017 were selected from our hospital and Zhoushan Hospital.Automated biochemical analyzer was adopted for the detection of alanine transferase(ALT),aspartate aminotransferase(AST),alkaline phosphatase(ALP),γ-glutamyltranspeptidase(GGT),lactate dehydrogenase(LDH),creatine Kinase(CK)and acid phosphatase(ACP).Clinical symptoms were collected for cluster analysis by K-Means method.ResultsAccording to clustering analysis,there were 16 cases in group A(AST~(high)/LDH~(high)/CK~(high)),6 cases in group B(AST~(high)/LDH~(low)/CK~(low)),14 cases in group C(ALT~(high)/LDH~(medium)/CK~(medium)).Rate of abdominal pain in group A(31.25%)was significantly higher than group B(0%)and group C(7.14%),with the differences statistically significant(χ~2=7.258,P<0.05).Rate of diarrhea in group A(68.75%)was significantly higher than group B(16.67%)and group C(28.57%),with the differences statistically significant(χ~2=7.132,P<0.05).ConclusionMore attention should be paid to digestive tract symptom in patients with AST~(high)/LDH~(high)/CK~(high).
引文
[1]李德新.发热伴血小板减少综合征布尼亚病毒概述[J].中华实验和临床病毒学杂志,2011,25(2):81-84.
[2]夏仕军,王忠发,李世波,等.岱山县新型布尼亚病毒分离与鉴定[J].中国卫生检验杂志,2014,24(3):368-371.
[3]唐晓燕,崔宁,康锴,等.一起聚集性新布尼亚病毒感染病例的诊断与治疗分析[J].中华预防医学杂志,2012,46(2):110-113.
[4]王超,窦相峰.新布尼亚病毒感染致发热伴血小板减少综合征的研究进展[J].中华地方病学杂志,2014,33(4):470-472.
[5]康锴,唐晓燕,许汴利,等.河南省2007-2011年发热伴血小板减少综合征流行特征分析[J].中华预防医学杂志,2012,46(2):106-109.
[6]尤爱国,杨建华,唐晓燕,等.新布尼亚病毒感染致发热伴血小板减少综合征的危险因素分析[J].中国人兽共患病学报,2015,31(8):704-708.
[7] Mueller Y,Bastard M,Ehounou G,et al. Effectiveness of blood transfusions and risk factors for mortality in children aged from 1month to 4 years at the Bon MarchéHospital,Bunia,Democratic Republic of the Congo[J]. Trop Med Int Health,2012,17(12):1457-1464.
[8]何卫华,郭芳,练祖银,等.随州市发热伴血小板减少综合征的流行病学特征研究[J].中国卫生检验杂志,2014,24(1):117-119.
[9]王子江,张洁,毛玲玲,等. 2010-2013年辽宁省发热伴血小板减少综合征流行特征[J].中华预防医学杂志,2016,50(4):362-363.
[10]蔡春林,陈戊申,阳帆,等.深圳地区疑似流行性出血热患者SFTSV血清学调查[J].中国卫生检验杂志,2015,25(12):2011-2015.
[11]中华人民共和国卫生部.发热伴血小板减少综合征防治指南(2010版)[J].中华临床感染病杂志,2011,4(4):193-194.
[12]何金林.新布尼亚感染检测进展[J].中国卫生检验杂志,2012,22(12):3055-3056.
[13]吕惠荣,杨云惠,杜燕华,等.新布尼亚病毒核酸检测实时荧光RT-PCR方法的评价[J].中国卫生检验杂志,2013,23(5):1186-1188.
[14]傅松维,胡逢蛟,王忠发,等.新布尼亚病毒Ig G抗体间接免疫荧光检测方法的建立与应用[J].中华检验医学杂志,2015,38(1):59-61.
[15]黄学勇,杜燕华,李幸乐,等.新布尼亚病毒Ig G抗体间接免疫荧光检测方法的建立[J].中华预防医学杂志,2012,46(2):165-168.
[2]夏仕军,王忠发,李世波,等.岱山县新型布尼亚病毒分离与鉴定[J].中国卫生检验杂志,2014,24(3):368-371.
[3]唐晓燕,崔宁,康锴,等.一起聚集性新布尼亚病毒感染病例的诊断与治疗分析[J].中华预防医学杂志,2012,46(2):110-113.
[4]王超,窦相峰.新布尼亚病毒感染致发热伴血小板减少综合征的研究进展[J].中华地方病学杂志,2014,33(4):470-472.
[5]康锴,唐晓燕,许汴利,等.河南省2007-2011年发热伴血小板减少综合征流行特征分析[J].中华预防医学杂志,2012,46(2):106-109.
[6]尤爱国,杨建华,唐晓燕,等.新布尼亚病毒感染致发热伴血小板减少综合征的危险因素分析[J].中国人兽共患病学报,2015,31(8):704-708.
[7] Mueller Y,Bastard M,Ehounou G,et al. Effectiveness of blood transfusions and risk factors for mortality in children aged from 1month to 4 years at the Bon MarchéHospital,Bunia,Democratic Republic of the Congo[J]. Trop Med Int Health,2012,17(12):1457-1464.
[8]何卫华,郭芳,练祖银,等.随州市发热伴血小板减少综合征的流行病学特征研究[J].中国卫生检验杂志,2014,24(1):117-119.
[9]王子江,张洁,毛玲玲,等. 2010-2013年辽宁省发热伴血小板减少综合征流行特征[J].中华预防医学杂志,2016,50(4):362-363.
[10]蔡春林,陈戊申,阳帆,等.深圳地区疑似流行性出血热患者SFTSV血清学调查[J].中国卫生检验杂志,2015,25(12):2011-2015.
[11]中华人民共和国卫生部.发热伴血小板减少综合征防治指南(2010版)[J].中华临床感染病杂志,2011,4(4):193-194.
[12]何金林.新布尼亚感染检测进展[J].中国卫生检验杂志,2012,22(12):3055-3056.
[13]吕惠荣,杨云惠,杜燕华,等.新布尼亚病毒核酸检测实时荧光RT-PCR方法的评价[J].中国卫生检验杂志,2013,23(5):1186-1188.
[14]傅松维,胡逢蛟,王忠发,等.新布尼亚病毒Ig G抗体间接免疫荧光检测方法的建立与应用[J].中华检验医学杂志,2015,38(1):59-61.
[15]黄学勇,杜燕华,李幸乐,等.新布尼亚病毒Ig G抗体间接免疫荧光检测方法的建立[J].中华预防医学杂志,2012,46(2):165-168.