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首页> 美国卫生研究院文献>The American Journal of Tropical Medicine and Hygiene >Different Patterns in a Cohort of Patients with Severe Leptospirosis (Weil Syndrome): Effects of an Educational Program in an Endemic Area
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Different Patterns in a Cohort of Patients with Severe Leptospirosis (Weil Syndrome): Effects of an Educational Program in an Endemic Area

机译：严重钩端螺旋体病（威尔综合症）患者队列的不同模式：流行地区教育计划的影响

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摘要

The aim of this study is to investigate the changes in clinical pattern and therapeutic measures in leptospirosis-associated acute kidney injury; a retrospective study with 318 patients in Brazil. Patients were divided according to the time of admission: 1985–1996 (group I) and 1997–2010 (group II). Patients were younger in group I (36 ± 13 versus 41 ± 16 years, P = 0.005) and the numbers of oliguria increased (21% versus 41% in group II, P = 0.014). Higher frequency of lung manifestations was observed in group II (P < 0.0001). Although increased severity, there was a significant reduction in mortality (20% in group I versus 12% in group II, P = 0.03). Mortality was associated with advanced age, low diastolic blood pressure, oliguria, arrhythmia, and peritoneal dialysis, besides a trend to better mortality with penicillin administration. Leptospirosis is occurring in an older population, with a higher number of oliguria and lung manifestations. However, mortality is decreasing and can be the result of changes in treatment.
机译：这项研究的目的是调查钩端螺旋体病相关的急性肾脏损伤的临床模式和治疗措施的变化。一项对巴西318例患者的回顾性研究。根据入院时间划分患者：1985-1996年（第一组）和1997-2010年（第二组）。 I组患者较年轻（36±13岁vs 41±16岁，P = 0.005），少尿数量增加（II组21％vs 41％，P = 0.014）。在第二组中观察到较高的肺部表现频率（P <0.0001）。尽管严重程度有所提高，但死亡率却显着降低（I组为20％，II组为12％，P = 0.03）。死亡率与高龄，舒张压低，少尿，心律不齐和腹膜透析有关，此外青霉素给药有使死亡率提高的趋势。钩端螺旋体病发生在老年人口中，少尿和肺部表现较多。但是，死亡率正在下降，可能是治疗方法改变的结果。

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