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济州岛一家三级医院10年间重症发热伴血小板减少综合征患者的流行病学和临床特征

Epidemiologic and Clinical Characteristics of Patients with Severe Fever with Thrombocytopenia Syndrome at Tertiary Hospital in Jeju for 10 years.

作者信息

Kim Jae Yeon, Yoo Jeong Rae, Kim Misun, Oh Hyunjoo, Heo Sang Taek

机构信息

College of Medicine, Catholic Kwandong University, International St. Mary's Hospital, Incheon, Korea.

Division of Infectious Diseases, Department of Internal Medicine, Jeju National University College of Medicine, Jeju, Korea.

出版信息

Infect Chemother. 2023 Sep;55(3):377-387. doi: 10.3947/ic.2023.0035. Epub 2023 Jun 13.

Abstract

BACKGROUND

Severe fever with thrombocytopenia syndrome (SFTS), which was first discovered in China in 2009, is an infectious disease with a high mortality rate, particularly in East Asia. This study aimed to investigate the epidemiological and clinical characteristics and risk factors for mortality by analyzing SFTS cases accumulated for up to ten years in Jeju, Korea.

MATERIALS AND METHODS

Medical records of patients diagnosed with SFTS between March 2013 and August 2022 at a tertiary hospital in Jeju were analyzed retrospectively. We investigated data of patients with SFTS on the epidemiologic and clinical characteristics, laboratory findings, and administered treatments and compared the differences between fatal and non-fatal groups.

RESULTS

We enrolled 91 SFTS-confirmed patients. The median age of patients was 62 years, and the fatality rate increased with age ( = 0.004). Fever was the most common symptom (84.6%), and diarrhea (37.4%) was also present in some cases. The overall fatality rate was 10.9%. Dyspnea (20.0% 0.0%, = 0.009) and changes in mental status (70.0% 11.0%, <0.001) were more frequent in fatal cases. Risk factor assessment revealed that a high aspartate aminotransferase /alanine aminotransferase ratio (odds ratio [OR]: 39.568, 95% confidence interval [CI]: 1.479 - 1,058.639, = 0.028) and elevated total bilirubin levels (OR: 53.037, 95% CI: 1.064 - 2,643.142, = 0.046) were also significantly associated with fatal cases. Plasma exchange (40.7%) was the most commonly administered treatment.

CONCLUSION

SFTS has a high mortality rate; therefore, awareness of SFTS must be raised among physicians and citizens living in tick-inhabited areas, such as Jeju.

摘要

背景

严重发热伴血小板减少综合征(SFTS)于2009年在中国首次发现,是一种死亡率很高的传染病,在东亚地区尤为如此。本研究旨在通过分析韩国济州岛累计长达十年的SFTS病例,调查其流行病学和临床特征以及死亡风险因素。

材料与方法

回顾性分析2013年3月至2022年8月期间济州岛一家三级医院诊断为SFTS的患者的病历。我们调查了SFTS患者的流行病学和临床特征、实验室检查结果以及所接受的治疗,并比较了死亡组和非死亡组之间的差异。

结果

我们纳入了91例确诊为SFTS的患者。患者的中位年龄为62岁,死亡率随年龄增长而升高(P = 0.004)。发热是最常见的症状(84.6%),部分病例还出现腹泻(37.4%)。总体死亡率为10.9%。呼吸困难(20.0%对0.0%,P = 0.009)和精神状态改变(70.0%对11.0%,P <0.001)在死亡病例中更为常见。风险因素评估显示,天冬氨酸转氨酶/丙氨酸转氨酶比值高(比值比[OR]:39.568,95%置信区间[CI]:1.479 - 1,058.639,P = 0.028)和总胆红素水平升高(OR:53.037,95%CI:1.064 - 2,643.142,P = 0.046)也与死亡病例显著相关。血浆置换(40.7%)是最常用的治疗方法。

结论

SFTS死亡率很高;因此,必须提高居住在蜱虫栖息地地区(如济州岛)的医生和居民对SFTS的认识。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/732a/10551713/948438129136/ic-55-377-g001.jpg

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