Yang Mengke, Yang Yang, Zhang Aiping, Ni Mingyue, Liang Manman, Quan Bin, Han Wenzheng, Yang Jianghua
Department of Infectious Diseases, The First Affiliated Hospital of Wannan Medical College, China.
Class 1, Grade 2019, Department of Stomatology, Bengbu Medical College, China.
Jpn J Infect Dis. 2024 May 23;77(3):121-128. doi: 10.7883/yoken.JJID.2022.571. Epub 2023 Dec 28.
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease. Previous studies have primarily focused on the epidemiological and clinical characteristics of patients with SFTS, whereas pancreatic injury has received little attention. This study investigated the effects of pancreatic injury on the prognosis of patients with SFTS. A total of 156 patients diagnosed with SFTS between April 2016 and April 2022 were included in the analysis. Multivariate logistic regression analysis showed that pancreatic injury (odds ratio [OR] = 3.754, 95% confidence interval [CI]: 1.361-79.036, P = 0.024) and neurological symptoms (OR = 18.648, 95% CI: 4.921-70.668, P < 0.001) were independent risk factors for mortality. The receiver operating characteristic curve indicated that serum pancreatic enzymes were predictive of progression to death in patients with SFTS. The area under the curve (AUC) for amylase was 0.711, with an optimal cutoff value of 95.5 U/L, sensitivity of 96.4%, and specificity of 35.9%. Lipase had an AUC of 0.754, an optimal cutoff value of 354.75 U/L, sensitivity of 75%, and specificity of 67.2%. Thus, pancreatic injury was associated with a poor prognosis of SFTS and can be used as an important reference for SFTS determination and prognostic assessment.
严重发热伴血小板减少综合征（SFTS）是一种新发传染病。既往研究主要聚焦于SFTS患者的流行病学和临床特征，而胰腺损伤很少受到关注。本研究调查了胰腺损伤对SFTS患者预后的影响。分析纳入了2016年4月至2022年4月期间诊断为SFTS的156例患者。多因素logistic回归分析显示，胰腺损伤（比值比[OR]=3.754，95%置信区间[CI]：1.361-79.036，P=0.024）和神经症状（OR=18.648，95%CI：4.921-70.668，P<0.001）是死亡的独立危险因素。受试者工作特征曲线表明，血清胰腺酶可预测SFTS患者的死亡进展。淀粉酶的曲线下面积（AUC）为0.711，最佳截断值为95.5 U/L，敏感性为96.4%，特异性为35.9%。脂肪酶的AUC为0.754，最佳截断值为354.75 U/L，敏感性为75%，特异性为67.2%。因此，胰腺损伤与SFTS的不良预后相关，可作为SFTS诊断和预后评估的重要参考。
