【摘要】 目的观察肾综合征出血热(HFRS)并发暂时性再生障碍性贫血危象(TAC)的临床特点、疗效和预后,探讨其发病机制。方法对18例HFRS并发TAC病人进行临床特点分析。结果18例(男10,女8)HFRS患者,年龄14~55岁,于病情严重阶段(病后9~25 d)出现不规则发热、突发性贫血和多部位出血,外周血白细胞降至(2.3~3.2)×109/L,血小板记数降至(23~31)×109/L,红细胞降至(2.23~2.79)×1012/L,血红蛋白降至52~67 g/L,网织红细胞0~0.002,骨髓穿刺(56次)示红细胞系增生降低,粒红细胞比例明显升高,粒细胞系和巨核细胞系增生降低,确诊为HFRS并发TAC。TAC的表现为突发性贫血、不规则发热和多部位出血。治疗的关键是采用肾上腺皮质激素和输血为主的综合性治疗措施,于病后26~60 d治愈。结论HFRS可以并发TAC,其预后良好。更多还原

【Abstract】 Objective To explore the pathologic mechanism by studing the clinical characteristics,curative effects and prognsis of hemorrhagic fever of nephrotic syndrome（HGFNS） complicated by transient aplastic crisis（TAC）.Methods 18 cases of HFNS with TAC were selected to observe their clinical characteristics.Results HFNS with TAC was confirmed in 18 cases aged 14～55（10 males and 8females）according to the following clinical characteristics in the severe stage（9～25 days after attacks）:irregular hemorrhage,transient anemia,multi-site hemorrhage,peripheral leukocyte count of （2.3～3.2）×10⁹/L,platelet count of（23～31）×10⁹/L,erythrocyte count of（2.23～2.79）×10¹²/L,hemoglobin content of（52～67）g/L,index of reticulocyte of 0～0.002,decrease in erythrocytic series confirmed by bone marrow punctures （56 times）,increase in granular red cells and decrease in granulocyte series and megakaryocytic series.The clinical manifestations of TAC were transient anemia,irregular fever and multi-site hemorrhage.Adrenocortical hormone application and blood transfasion can be used to treat the disease.All cases recovered after 26～60 days of treatments.Conclusion HFNS can occur with TAC,but the prognosis turns out to be good.更多还原