Department of Infectious Disease, Zhongnan Hospital of Wuhan University, Wuhan, China.
Department of Infectious Diseases, Tongji Hospital, Tongji Medical College and State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Disease, Huazhong University of Science and Technology, Wuhan, China.
BMC Infect Dis. 2024 Jan 30;24(1):149. doi: 10.1186/s12879-024-09026-4.
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging zoonosis with a high fatality rate in China. Previous studies have reported that dysregulated inflammatory response is associated with disease pathogenesis and mortality in patients with SFTS. This investigation aimed to evaluate the prevalence and characteristics of systemic inflammatory response syndrome (SIRS), and its impact on prognosis.
Data on demographic characteristics, comorbid conditions, clinical manifestations, laboratory parameters, and survival time of patients with SFTS were collected. Patients were divided into the non-SIRS and SIRS groups according to the presence of SIRS, then their clinical data were compared.
A total of 290 patients diagnosed with SFTS were retrospectively enrolled, including 126(43.4%) patients with SIRS. Patients in the non-survivor group had more prevalence of SIRS than patients in the survivor group (P < 0.001), and SIRS (adjusted OR 2.885, 95% CI 1.226-6.786; P = 0.005) was shown as an independent risk factor for prognosis of patients with SFTS. Compared with patients without SIRS, patients with SIRS had lower WBC and neutrophils counts, and fibrinogen levels, but higher AST, LDH, amylase, lipase, CK, CK-MB, troponin I, APTT, thrombin time, D-dimer, CRP, IL-6, SAA levels, and viral load. The cumulative survival rate of patients with SIRS was significantly lower than that of patients without SIRS. Patients with SIRS also showed a higher incidence of bacterial or fungal infections than patients without SIRS.
SIRS is highly frequent in patients with SFTS, and it is associated with high mortality.
严重发热伴血小板减少综合征（SFTS）是一种在中国具有高病死率的新兴人畜共患病。先前的研究表明，失调的炎症反应与 SFTS 患者的发病机制和死亡率有关。本研究旨在评估全身炎症反应综合征（SIRS）的流行率和特征及其对预后的影响。
收集了 SFTS 患者的人口统计学特征、合并症、临床表现、实验室参数和生存时间的数据。根据是否存在 SIRS 将患者分为非 SIRS 组和 SIRS 组，然后比较其临床数据。
共回顾性纳入 290 例 SFTS 患者，其中 126 例（43.4%）患者存在 SIRS。非幸存者组中 SIRS 的发生率高于幸存者组（P<0.001），SIRS（调整后的 OR 2.885，95%CI 1.226-6.786；P=0.005）是 SFTS 患者预后的独立危险因素。与无 SIRS 的患者相比，SIRS 患者的白细胞和中性粒细胞计数、纤维蛋白原水平较低，但 AST、LDH、淀粉酶、脂肪酶、CK、CK-MB、肌钙蛋白 I、APTT、凝血酶时间、D-二聚体、CRP、IL-6、SAA 水平和病毒载量较高。SIRS 患者的累积生存率明显低于无 SIRS 患者。SIRS 患者的细菌或真菌感染发生率也高于无 SIRS 患者。
SIRS 在 SFTS 患者中发生率较高，与高死亡率相关。
