Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China.
J Med Virol. 2021 Jun;93(6):3516-3523. doi: 10.1002/jmv.26544. Epub 2020 Oct 8.
This study described the clinical features, risk factors, factors affecting the outcome of this disease, and ribavirin therapeutic efficacy for severe fever with thrombocytopenia syndrome (SFTS) patients in Hefei.
Between April 2020 and July 2020, 62 cases admitted to the First Affiliated Hospital of Anhui Medical University were included in this study. Serum samples were collected from all patients, after which diagnosis was made via reverse transcription-polymerase chain reaction and via the use of a colloidal gold immunochromatography assay approach.
In multivariate analysis, the following factors were determined as risk factors for SFTS: Being a farmer (odds ratio [OR], 3.033), working in areas with weeds and shrubs (OR, 2.807), and being bitten by a tick (OR, 6.64). The rates of confusion, neck stiffness, viral encephalopathy, and the presence of liver damage were higher in the patients who died than that in the surviving ones. Additionally, the median of alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, creatine phosphokinase, activated partial thromboplastin time, D-dimer, fibrinogen degradation products, creatinine, and urea was also higher in the patients who died. One of the 15 patients treated with ribavirin in the early stage could not survive (6.7%), whereas 11 of the 35 patients treated with ribavirin in the late stage could not survive (31.4%); this difference was statistically significant. However, there was no significant difference in mortality between the untreated group and the other two groups (i.e., patients who started antiviral treatment <5 days from the onset and those who started antiviral treatment ≥5 days from the onset). Moreover, there was no positive effect determined on clinical or laboratory parameters in SFTS patients treated with ribavirin. Also, it was observed that leukocyte levels and platelet levels took longer to return to normal.
In Hefei, clinical features, prognostic factors, and risk factors associated with SFTS are similar to those in other areas. Patients who were given ribavirin did not have better survival rates than patients who were not given ribavirin.
本研究描述了发热伴血小板减少综合征（SFTS）在合肥的临床特征、危险因素、影响疾病结局的因素以及利巴韦林的治疗效果。
本研究纳入了 2020 年 4 月至 7 月期间入住安徽医科大学第一附属医院的 62 例患者。采集所有患者的血清样本，通过逆转录-聚合酶链反应（RT-PCR）和胶体金免疫层析法进行诊断。
多因素分析显示，SFTS 的危险因素包括：农民（比值比 [OR]，3.033）、工作于杂草丛生和灌木丛生地区（OR，2.807）、被蜱虫叮咬（OR，6.64）。死亡患者出现意识模糊、颈项强直、病毒性脑炎和肝损伤的比例高于存活患者。此外，死亡患者的丙氨酸氨基转移酶、天冬氨酸氨基转移酶、乳酸脱氢酶、肌酸磷酸激酶、活化部分凝血活酶时间、D-二聚体、纤维蛋白原降解产物、肌酐和尿素中位数也较高。在早期接受利巴韦林治疗的 15 例患者中，有 1 例（6.7%）无法存活，而在晚期接受利巴韦林治疗的 35 例患者中，有 11 例（31.4%）无法存活，差异具有统计学意义。然而，未接受抗病毒治疗组与其他两组（即发病 5 天内开始抗病毒治疗组和发病 5 天以上开始抗病毒治疗组）之间的死亡率无显著差异。此外，利巴韦林治疗对 SFTS 患者的临床或实验室参数无明显改善作用，且观察到白细胞和血小板水平恢复正常的时间更长。
在合肥，SFTS 的临床特征、预后因素和危险因素与其他地区相似。接受利巴韦林治疗的患者的生存率并不优于未接受利巴韦林治疗的患者。
