摘要
目的了解内脏利什曼病死亡病例的临床特点及实验室指标变化特征。方法分析北京友谊医院2013年1月—2018年6月4例内脏利什曼病死亡患者的临床资料,比较患者实验室指标的差异。结果 4例内脏利什曼病患者的病程3~12个月,患者均出现了多脏器的损伤,其中3例肝、脾大,2例出现中枢神经系统的损伤。4例患者利什曼原虫IgG抗体为阳性,骨髓涂片中均找到了利杜体。4例患者外周血常规的三系明显降低,清蛋白明显降低,球蛋白升高;4例患者的血清钠离子含量低于135 mmol/L。结论内脏利什曼病患者出现病程长,多脏器损伤,累及中枢神经系统,外周血常规三系显著降低,低蛋白血症,以及低钠血症均提示预后差,病死率高。
Objective To understand the clinical characteristics and changes in laboratory indicators of patients died of visceral leishmaniasis(VL).Methods Clinical data of 4 patients died of VL in Beijing Friendship Hospital from January 2013 to June 2018 were analyzed,differences in laboratory indicators were compared.Results Disease course of 4 cases of VL ranged from3 to 12 months,all patients had multiple organ damage,including 3 cases with hepatomegaly and splenomegaly,2 cases with central nervous system damage.IgG antibodies of leishmania were positive in 4 patients,Leishman-Donovan body was found in bone marrow smears.Routine peripheral blood test results in 4 patients decreased significantly,albumin decreased significantly and globulin increased;level of serum sodium ion in 4 patients was lower than 135 mmol/L.Conclusion Long disease course,multiple organ damage,involvement of central nervous system,significant reducing in peripheral blood routine test results,hypoproteinemia,and hyponatremia in patients with VL all indicate poor prognosis and high mortality.
引文
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