Department of Infectious Diseases, Yidu Central Hospital of Weifang Affiliated to Weifang Medical University, Weifang, Shandong, China (mainland).
Emergency Department, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China (mainland).
Med Sci Monit. 2023 Mar 24;29:e938427. doi: 10.12659/MSM.938427.
BACKGROUND Severe fever with thrombocytopenia syndrome (SFTS) is a zoonotic viral hemorrhagic fever caused by the SFTS virus (SFTSV), which is a newly identified tick-borne bunyavirus, recently named Dabie bandavirus. In rural China, SFTSV or Dabie bandavirus is commonly transmitted by Haemaphysalis longicornis, the Asian longhorned tick. In recent years, SFTS has been of great concern due to its high morbidity and mortality. The present study investigated the risk factors for mortality in patients with SFTS complicated by central nervous system involvement. MATERIAL AND METHODS We studied 69 SFTS patients hospitalized between 2013 and 2020. We analyzed the laboratory test results and clinical data through univariate and multivariate regression. RESULTS Neurological complications occurred in 59 patients in the survival group and 10 in the mortality group. No significant gender difference was found between the 2 groups. No significant difference was found in age, hospitalization duration, or occurrence of encephalitis between the 2 groups. The mean duration of hospitalization and course of the disease in the mortality group were significantly shorter than those in the survival group (P<0.01). The mean values of platelet count, potassium, and sodium in the mortality group were significantly lower, while the mean values of aspartate aminotransferase, lactic dehydrogenase, creatine kinase-MB (CK-MB) and procalcitonin were higher than those in the survival group. Low platelet count and high CK-MB were independent risk factors for mortality in patients. For each unit increase in platelet count, the risk of mortality decreased by 24.2%, and for each unit increase in CK-MB, the probability of mortality increased by 118.6%. CONCLUSIONS Decreased platelets and increased CK-MB were independent risk factors for mortality in encephalitis patients. SFTS patients with encephalitis should be monitored for changes in these 2 indicators.
严重发热伴血小板减少综合征（SFTS）是一种由 SFTS 病毒（SFTSV）引起的人畜共患病毒性出血热，SFTSV 是一种新发现的蜱传 bunyavirus，最近被命名为大别山病毒。在中国农村，SFTSV 或大别山病毒通常通过长角血蜱传播，长角血蜱是亚洲长角血蜱。近年来，由于 SFTS 的高发病率和死亡率，SFTS 引起了极大的关注。本研究调查了伴有中枢神经系统受累的 SFTS 患者死亡的危险因素。
我们研究了 2013 年至 2020 年间住院的 69 例 SFTS 患者。通过单因素和多因素回归分析了实验室检测结果和临床资料。
在存活组中，59 例患者出现神经系统并发症，10 例患者在死亡组中出现神经系统并发症。两组间无明显性别差异。两组间年龄、住院时间或脑炎发生率无显著差异。死亡组的平均住院时间和病程明显短于存活组（P<0.01）。死亡组血小板计数、钾和钠的平均值明显较低，而天冬氨酸转氨酶、乳酸脱氢酶、肌酸激酶同工酶-MB（CK-MB）和降钙素原的平均值明显较高。血小板计数低和 CK-MB 高是患者死亡的独立危险因素。血小板计数每增加一个单位，死亡风险降低 24.2%，CK-MB 每增加一个单位，死亡概率增加 118.6%。
血小板减少和 CK-MB 升高是脑炎患者死亡的独立危险因素。SFTS 合并脑炎的患者应监测这 2 项指标的变化。
