Hu Jianhua, Li Siying, Zhang Xuan, Zhao Hong, Yang Meifang, Xu Lichen, Li Lanjuan
State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou Department of Infections, Hangzhou First People's Hospital, Nanjing Medical University, Hangzhou, Zhejiang Province, China.
Medicine (Baltimore). 2018 Jun;97(22):e10848. doi: 10.1097/MD.0000000000010848.
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging high-fatality infectious disease caused by a novel phlebovirus belonging to the Bunyaviridae family. Thus, the independent predictors of death in this disease must be identified to improve the survival of affected patients.A total of 25 hospitalized patients with SFTS virus infection were enrolled in our study, and their medical records and laboratory data were reviewed. The risk factors for death were examined by binary logistic regression.The patient age was significantly higher in the deceased cases than in those who recovered (P = .020). Moreover, the occurrence of shock, respiratory failure, hemorrhagic manifestations, kidney dysfunction, and arrhythmia was significantly more common in the deceased cases than in the recovered cases (P = .016, P = .004, P = .005, P = .002, P = .038). Univariate binary logistic regression showed that shock, arrhythmia, and hemorrhage, as well as PCT, serum creatinine (Scr), and blood urea nitrogen (BUN) elevations, were the risk factors for death (odds ratio, OR 28.5, P = .015; OR 13.5, P = .027; OR 36, P = .008; OR 28.5, P = .015; OR 36, P = .008; and OR 76.0, P = .004). However, the BUN increase was the only independent risk factor for death indicated by multivariate logistic regression (OR 76.0, P = .004).SFTS presents with a high fatality rate. When patients with SFTS manifest shock, arrhythmia, hemorrhage, PCT increase, and Scr and BUN elevations, especially BUN > 8.2 μmol/L, health care providers should be alerted and must administer early intervention to prevent the progress to death.
发热伴血小板减少综合征(SFTS)是一种由属于布尼亚病毒科的新型静脉病毒引起的、致死率高的新发传染病。因此,必须确定该疾病死亡的独立预测因素,以提高受影响患者的生存率。
本研究共纳入25例住院的SFTS病毒感染患者,并对其病历和实验室数据进行了回顾。通过二元逻辑回归分析死亡的危险因素。
死亡病例的患者年龄显著高于康复病例(P = 0.020)。此外,休克、呼吸衰竭、出血表现、肾功能不全和心律失常在死亡病例中的发生率显著高于康复病例(P = 0.016、P = 0.004、P = 0.005、P = 0.002、P = 0.038)。单因素二元逻辑回归显示,休克、心律失常、出血以及降钙素原(PCT)、血清肌酐(Scr)和血尿素氮(BUN)升高是死亡的危险因素(比值比,OR 28.5,P = 0.015;OR 13.5,P = 0.027;OR 36,P = 0.008;OR 28.5,P = 0.015;OR 36,P = 0.008;OR 76.0,P = 0.004)。然而,多因素逻辑回归显示BUN升高是唯一的死亡独立危险因素(OR 76.0,P = 0.004)。
SFTS的病死率很高。当SFTS患者出现休克、心律失常、出血、PCT升高以及Scr和BUN升高,尤其是BUN>8.2μmol/L时,医护人员应提高警惕,必须尽早进行干预以防止病情进展至死亡。