Kim Uh Jin, Oh Tae Hoon, Kim Bansuk, Kim Seong Eun, Kang Seung-Ji, Park Kyung-Hwa, Jung Sook-In, Jang Hee-Chang
Department of Infectious Diseases, Chonnam National University Medical School, Gwangju, Republic of Korea.
Dis Markers. 2017;2017:6727184. doi: 10.1155/2017/6727184. Epub 2017 Feb 28.
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging viral disease in East Asia with high mortality. Few studies have examined markers that suggest SFTS in febrile patients. To determine useful biochemical markers for SFTS, patients aged 18 years or older with SFTS or microbiologically confirmed community-onset bacteremia with thrombocytopenia (BT) at presentation between June 2013 and December 2015 were included from two tertiary university hospitals in Republic of Korea retrospectively. Eleven patients with SFTS and 62 patients with bacteremia and thrombocytopenia were identified in the study period. Age and sex did not show significant difference among two groups. Fever was more commonly observed but comorbidities were less common in SFTS than in BT ( < 0.05, each). The areas under the curves of serum ferritin, C-reactive protein, white blood cell count, serum procalcitonin, and fibrinogen were above 0.9, indicating the discriminative power of these biomarkers (1.000, 0.991, 0.963, 0.931, and 0.934, resp., all < 0.05). The optimal cutoff value of serum ferritin was 3,822 ng/mL in this study. These results suggest that hyperferritinemia is a typical laboratory feature of SFTS, and the serum ferritin level can be used as a marker for clinicians suspecting SFTS.
重症发热伴血小板减少综合征（SFTS）是东亚地区一种新出现的病毒性疾病，死亡率很高。很少有研究检测发热患者中提示SFTS的标志物。为了确定SFTS的有用生化标志物，我们回顾性纳入了2013年6月至2015年12月期间韩国两家三级大学医院收治的18岁及以上的SFTS患者或微生物学确诊的社区获得性血小板减少菌血症（BT）患者。在研究期间，共确定了11例SFTS患者和62例菌血症伴血小板减少患者。两组患者的年龄和性别无显著差异。与BT组相比，SFTS组发热更为常见，但合并症较少（均P<0.05）。血清铁蛋白、C反应蛋白、白细胞计数、血清降钙素原和纤维蛋白原的曲线下面积均大于0.9，表明这些生物标志物具有鉴别能力（分别为1.000、0.991、0.963、0.931和第0.934，均P<0.05）。本研究中血清铁蛋白的最佳截断值为3822 ng/mL。这些结果表明，高铁蛋白血症是SFTS的典型实验室特征，血清铁蛋白水平可作为怀疑SFTS的临床医生的一个标志物。
