Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Karadeniz Technical University, Trabzon, Turkey.
J Med Virol. 2012 Nov;84(11):1790-6. doi: 10.1002/jmv.23390.
The aim of this study was to investigate the predictive factors which contribute to diagnosis of hantavirus infection. One hundred patients from rural areas hospitalized with a preliminary diagnosis of hantavirus infection from different hospitals in Turkey were investigated. Hantavirus infection was confirmed in 20 patients (Group 1) using immunofluorescence and immunoblot assays at the Refik Saydam National Public Health Agency. Hantaviruses were not detected in the serum of the remaining 80 patients, other infectious and non-infectious diseases being diagnosed in this group (Group 2). Patients' demographic characteristics and clinical and laboratory data on admission were examined and compared between the two groups. Fever, proteinuria, hematuria, lethargy-weakness, and nausea-vomiting were the most frequent symptoms and findings in Group 1, seen in almost all patients. Proteinuria, hematuria, muscle pain, diarrhea/abdominal pain, hypotension, shock, and sweating were observed at significantly higher levels in Group 1 compared to Group 2. Serum urea, creatinine, uric acid, lactate dehydrogenase (LDH), aspartate transaminase (AST), alkaline phosphatase (ALP), and C-reactive protein (CRP) were significantly higher, but serum platelet counts were lower in Group 1 patients. Area beneath the receiver operating characteristics (ROC) curve analysis was used to calculate the discriminative ability of various laboratory values to identify patients with hantavirus infection. This analysis revealed that, serum CRP had a 100% negative predictive value, whilst, platelet, and creatinine had 75% and 70% positive predictive values for the diagnosis of hantavirus infection. In summary, laboratory markers used in clinical practice are of great importance predicting hantavirus infections.
本研究旨在探讨有助于汉坦病毒感染诊断的预测因素。我们调查了来自土耳其不同医院以汉坦病毒感染初步诊断住院的 100 名农村患者。在 Refik Saydam 国家公共卫生机构使用免疫荧光和免疫印迹检测法在 20 名患者（第 1 组）中确认了汉坦病毒感染。在其余 80 名患者的血清中未检测到汉坦病毒，该组诊断为其他感染性和非感染性疾病（第 2 组）。检查并比较了两组患者入院时的人口统计学特征、临床和实验室数据。发热、蛋白尿、血尿、乏力-虚弱和恶心-呕吐是第 1 组最常见的症状和发现，几乎所有患者均存在这些症状和发现。与第 2 组相比，第 1 组蛋白尿、血尿、肌肉疼痛、腹泻/腹痛、低血压、休克和出汗更为常见。与第 2 组相比，第 1 组患者血清尿素、肌酐、尿酸、乳酸脱氢酶（LDH）、天冬氨酸转氨酶（AST）、碱性磷酸酶（ALP）和 C 反应蛋白（CRP）明显更高，但血清血小板计数更低。Receiver operating characteristics (ROC) 曲线下面积分析用于计算各种实验室值区分汉坦病毒感染患者的能力。该分析表明，血清 CRP 具有 100%的阴性预测值，而血小板和肌酐对汉坦病毒感染的诊断具有 75%和 70%的阳性预测值。总之，临床实践中使用的实验室标志物对于预测汉坦病毒感染具有重要意义。
