天津医药

天津医药 ›› 2019, Vol. 47 ›› Issue (7): 738-741.doi: 10.11958/20190002

• 临床研究 • 上一篇    下一篇

74例发热伴血小板减少综合征临床特征分析

贺志权，袁春，崔宁，黄学勇，杜燕华，李懿，苏佳，许汴利，郭万申   

  1. 1郑州大学公共卫生学院流行病学教研室（邮编450001）；2信阳市解放军第一五四中心医院感染科；3河南省疾病预防控制中心传染病预防控制所
  • 收稿日期:2019-01-04 修回日期:2019-04-02 出版日期:2019-07-15 发布日期:2019-08-01
  • 通讯作者: 贺志权 E-mail:hezq518@163.com

The clinical characteristics of 74 cases of severe fever with thrombocytopenia syndrome

HE Zhi-quan,YUAN Chun,CUI Ning,HUANG Xue-yong,DU Yan-hua,LI Yi,SU Jia,XU Bian-li,GUO Wan-shen   

  1. 1 Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China; 2 Department of Infectious Disease, the 154 Hospital, Chinese People’s Liberation Army; 3 Institute for Infectious Disease Control and Prevention, Henan Provincial Center for Disease Control and Prevention
  • Received:2019-01-04 Revised:2019-04-02 Published:2019-07-15 Online:2019-08-01
  • Contact: Zhi-Quan HE E-mail:hezq518@163.com

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摘要： 目的 分析发热伴血小板减少综合征（SFTS）的临床特点，为该病的治疗提供参考。方法 对河南省信阳市解放军第一五四中心医院 2017年 8月—2018年 8月收集的 74例确诊病例资料进行回顾性分析，将患者分为轻症组（58例）和重症组（16例），比较2组临床表现、白细胞计数（WBC）、血小板计数（PLT）、天门冬氨酸转氨酶（AST）、丙氨酸转氨酶（ALT）、肌酸激酶（CK）、乳酸脱氢酶（LDH）、血尿素氮（BUN）等实验室检查指标的差异，Logistic回归分析SFTS重症患者的影响因素。结果 流行病学资料显示本组患者多为老年人，以农民居多，临床症状主要表现为发热、纳差、乏力、恶心、全身酸痛、淋巴结肿大。重症组纳差、腹泻、神志不清、胸闷气喘的发生比例高于轻症组（P＜0.05），实验室检查结果显示，重症组CK、BUN水平高于轻症组（P＜0.05），其余指标比较差异无统计学意义。Logistic回归分析结果显示，纳差（OR=5.207，95%CI：1.039~26.082）、CK≥200 U/L（OR=4.446，95%CI：1.231~16.058）是导致疾病由轻症向重症进展的危险因素。结论 纳差及CK水平的升高是病情加重的危险因素，临床上应该加强对这些因素的预防，降低死亡率。

关键词: 布尼亚病毒科感染, 发热伴血小板减少综合征, 肝功能不全, 临床特征

Abstract: Abstract: Objective To analyze the clinical characteristics of severe fever with thrombocytopenia syndrome (SFTS)and provide more theoretical basis for the treatment. Methods A retrospective analysis was performed on 74 confirmed cases collected from the 154 Hospital, Chinese People’s Liberation Army, Xinyang City, Henan Province from August 2017 to August 2018. The patients were divided into mild group (58 cases) and severe group (16 cases), and the differences in the clinical features and laboratory test were compared between the two groups, including white blood count (WBC), platelet (PLT), aspartate aminotransferase (AST), alanine aminotransferase (ALT), creatine kinase (CK), lactate dehydrogenase (LDH)and blood urea nitrogen (BUN). Multiple Logistic regression analysis was conducted to explore the risk factors in SFTS patients. Results The epidemiological data showed that most of patients were older farmers. Clinical features of SFTS patients contained fever, loss of appetite, fatigue, nausea, muscle pain and lymphadenectasis. The incidences of the loss of appetite, diarrhea, unconsciousness, chest distress and asthma were significantly higher in severe group than those in mild group (P＜0.05). The laboratory test showed that CK and BUN levels were significantly higher in severe group than those in mild group (P＜0.05), but there were no significant differences in the other indictors between the two groups. Logistic regression analysis showed that loss of appetite (OR=5.207, 95%CI：1.039-26.082) and CK≥200 U/L (OR=4.446，95%CI：1.231-16.058) were risk factors leading to the progression of disease from mild to severe. Conclusion The loss of appetite and increased level of CK are risk factors for the aggravation of the disease. These factors should be controlled in order to reduce mortality.

Key words: bunyaviridae infections, severe fever with thrombocytopenia syndrome, hepatic insufficiency, clinical feature