目的:了解云南省德宏地区丙型肝炎病毒(hepatitis C virus,HCV)基因型的分布特征。方法:选取2014年1月至2017年3月在云南省德宏州人民医院诊治的HCV RNA阳性患者276例,采集其血清样本,采用PCR反向点杂交法分析HCV基因型(1a、1b、2a、3a...
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目的:了解云南省德宏地区丙型肝炎病毒(hepatitis C virus,HCV)基因型的分布特征。方法:选取2014年1月至2017年3月在云南省德宏州人民医院诊治的HCV RNA阳性患者276例,采集其血清样本,采用PCR反向点杂交法分析HCV基因型(1a、1b、2a、3a、3b和6型);对不能确定型别的样本采用非结构蛋白5B(nonstructural protein 5B,NS5B)测序法进行分型。结果 :276例患者的HCV基因型中,主要为6型120例(43.48%)、3b型80例(28.99%),其次是1b型33例(11.96%)、3a型30例(10.87%)、1a型9例(3.26%)、2a型4例(1.45%)。其中德宏地区的患者有151例,主要为6型61例(40.40%)、3b型53例(35.10%),其次是1b型15例(9.93%)、3a型14例(9.27%)、1a型4例(2.65%)、2a型4例(2.65%)。将德宏地区151例基因分型分布结果与国内其他地区进行比较,结果提示差异有统计学意义,云南省德宏州地区的HCV 6型及3型(包括6n、6u、6a、6m、6型混合)所占百分比明显高于其他地区,而1a和2a型检出百分比较低(P<0.05)。结论:云南省德宏州地区的HCV基因亚型共检出9种,主要以3b型和6型为主,其次是1b型及3a型,与国内其他地区比较有显著差异,提示本地区HCV亚型有其独特性。
目的:筛选出重症登革热患者出现不良预后的独立危险因素,以期利用快速、准确的预警指标,为减少病情恶化、改善预后、降低登革热的重症率及死亡率提供一定的证据支持。方法:选取2023年01月~2024年01就诊于德宏州人民医院诊断重症登革热的患者,收集纳入对象的临床资料,将收集的数据创建Excel数据库,运用SPSS 26.0软件分析数据。结果:46例患者中,36例经治疗后好转出院,10例患者因治疗效果不佳死亡或因病情危重放弃治疗,登革热预后不良组与好转出院组相比较就诊时症状更严重且年龄较大,住院期间合并出血性并发症、重症肺炎、MODS、第三间隙积液的情况较多,且尿素、肌酐、降钙素、CRP、BNP、ALT、AST、白细胞、PT、APTT水平较高,血红蛋白、血小板水平较低;其中,CRP、白细胞、BNP、ALT、AST、PT、APTT水平升高、血小板水平降低为导致重症登革热患者出现预后不良的独立危险因素。结论:CRP、BNP、ALT、AST、白细胞、PT、APTT水平增高、血小板水平降低可能是重症登革热患者出现预后不良的独立风险,在临床工作中应对以上指标加以关注。Objective: Identifying independent risk factors for poor outcomes in severe dengue fever patients, with the aim of providing evidence-based support for reducing morbidity, improving prognosis, and reducing the incidence of severe dengue fever and mortality through the use of rapid and accurate early warning indicators. Methods: Patients diagnosed with severe dengue fever at Dehong People’s Hospital from January 2023 to January 2024 were selected. Clinical data of the included subjects were collected and used to create an Excel database. The data were then analyzed using SPSS 26.0 software. Results: Among the 46 patients, 36 improved and were discharged after treatment, while 10 patients died due to poor treatment outcomes or had treatment withdrawn because of critical illness. Compared with the group that improved and was discharged, the group with poor prognosis had more severe symptoms at the time of hospital visit and were older. During hospitalization, they had a higher incidence of complications such as hemorrhagic complications, severe pneumonia, MODS, and third-space fluid accumulation. Additionally, levels of urea, creatinine, procalcitonin, CRP, BNP, ALT, AST, white blood cells, PT, and APTT were higher, while levels of hemoglobin and platelets were lower. Among these, elevated levels of CRP, white blood cells, BNP, ALT, AST, PT, and APTT, as well as decreased platelet levels, were identified as independent risk factors for poor prognosis in patients with severe dengue fever. Conclus
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