哈夫病的单中心临床分析

目的:探讨我院哈夫病的临床特点,旨在提高对本病的认识并提供一些诊疗体会。方法:回顾性分析2016年7月~8月在我院肾病中心住院诊治的哈夫病患者,收集该人群的临床资料,并行统计学分析。结果:2016年7月至8月我科累计收治哈夫病患者66例,其中男性28例(42.4%),女性38例(57.6%),发病年龄35.5岁(18-76岁),潜伏期5.6小时(1-24小时),患者发病前均有食用小龙虾史,首发症状均为肌肉酸痛,部分伴有浓茶色尿(19例,28.8%);实验室检查提示转氨酶及肌酶升高明显(丙氨酸氨基转移酶、天冬氨酸氨基转移酶、乳酸脱氢酶、磷酸肌酸激酶、肌红蛋白,肌酸激酶同工酶),部分患者尿检异常,尿隐血阳性(45%)、尿蛋白阳性(16.7%)。经治疗后所有患者肌肉酸痛症状缓解,尿色转清,复查上述转氨酶及肌酶均明显下降(P0.05),尿隐血及蛋白均转阴。结论:南京哈夫病夏季高发,与食用小龙虾有相关性,潜伏期短,首发症状多为肌肉酸痛,伴或不伴有肌红蛋白尿,实验室检查示血清磷酸肌酸激酶、肌红蛋白、肌酸激酶同工酶升高明显,疗程短,预后佳,一般不留后遗症。

Clinical Analyzation of Patients with Haff Disease in a Single Center

ABSTRACT Objective: To explore the clinical characteristics of Haff disease in our hospital, be familiar with the disease and pro- vide some experience in diagnosis and treatment. Methods: Inpatients with Haff disease in our Kidney disease center between July and August 2016 were retrospectively analyzed. The clinical data of patients was collected and statistically analyzed. Results: There were 66 patients (28 of male and 38 of female) in total with Haff disease between July and August 2016 in our ward. The average onset age was 35.5 years old (18-76 years old) and the average latency period was 5.6 hours (1-24 hours). All the patients had crayfish before the onset of the disease. The initial symptoms included muscle pain and concentrated brown urine (19 cases, 28.8%). Laboratory tests suggested that transaminase and myotropin were increased significantly (alanine aminotransferase, aspartate aminotransferase, lactate dehydroge- nase, creatine kinase, myoglobin and creatine kinase isoenzyme). A trace of blood (45%) and protein (16.7%) was present in some pa- tients'' urine test. After treatment, muscle pain was alleviated and urine color turned to clear in all patients. All the transaminase and mus- cle enzymes were significantly decreased (P<0.05). No blood or protein was detected in the urine test. Conclusion: The epidemiology of Haff disease in summer at Nanjing was related to the intake of crayfish. The latency period was short and the initial symptoms were most- ly muscle soreness, with or without myoglobinuria. Laboratory tests showed serum creatine phosphokinase, myoglobin, creatine kinase isoenzymes were increased significantly. The treatment period was short with good prognosis. Generally no sequelae was observed.