Xia Yanyan, Jia Bei, Chen Yuxin, Wang Sen, Xu Xuejing
Department of Clinical Laboratory Medicine, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.
Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.
Front Microbiol. 2024 Apr 3;15:1335664. doi: 10.3389/fmicb.2024.1335664. eCollection 2024.
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease caused by a novel bunyavirus infection with a high lethality rate. The purpose of this study was to investigate the changes in coagulation parameters in patients with SFTS, aiming to provide clinical evidence for early diagnosis, treatment, and disease analysis.
A total of 40 patients with SFTS attended from April 1, 2020 to May 21, 2022 in Nanjing Drum Tower Hospital were selected and grouped according to the duration of the disease, mild and severe disease, cure and death, with 50 healthy physical examiners as controls, and the risk of severe and death disease was predicted using ROC curves.
Comparison between the healthy, mild and severe groups revealed that PT, INR, APTT, TT, D-D and vWF levels were higher than those in the healthy control group, and FII, FIX, FX, FXI, FXII, PC and PS levels were lower than those in the healthy control group, the differences were statistically significant ( < 0.05). Comparing the results of SFTS patients with different course times, the results of Fib, FV, FVII, FVIII, FIX, FX, FXI were statistically significant ( < 0.05). Among the survived and deceased patients, the PT, INR, DD and PS results of the deceased patients were higher than those of the survived patients, and the FVIII, FIX, FXI, FXII and PC were lower than those of the survived patients. The area under the ROC curve showed that D-D had higher predictive ability for the risk of severe disease (AUROC 0.93, sensitivity and specificity at a Cut-off value of 1.50 mg/L were 90.0 and 86.5%, respectively) and the risk of death occurring (AUROC 0.84, sensitivity and specificity at a Cut-off value of 3.39 mg/L were 87.5 and 80.0%, respectively).
The monitoring of the coagulation parameters in patients with SFTS is great significance for identifying the severity and death of the patient's condition, and it is of great clinical value to provide early attention, timely intervention and maximum reduction of the mortality rate for patients at risk of severe disease.
发热伴血小板减少综合征（SFTS）是一种由新型布尼亚病毒感染引起的新发传染病，致死率高。本研究旨在探讨SFTS患者凝血参数的变化，为早期诊断、治疗及病情分析提供临床依据。
选取2020年4月1日至2022年5月21日在南京鼓楼医院就诊的40例SFTS患者，根据病程、病情轻重、治愈与死亡情况进行分组，并选取50名健康体检者作为对照，采用ROC曲线预测重症和死亡风险。
健康组、轻症组和重症组比较，PT、INR、APTT、TT、D - D及vWF水平高于健康对照组，FII、FIX、FX、FXI、FXII、PC及PS水平低于健康对照组，差异有统计学意义（<0.05）。比较不同病程SFTS患者结果，Fib、FV、FVII、FVIII、FIX、FX、FXI差异有统计学意义（<0.05）。存活与死亡患者中，死亡患者的PT、INR、DD及PS结果高于存活患者，FVIII、FIX、FXI、FXII及PC低于存活患者。ROC曲线下面积显示，D - D对重症风险具有较高预测能力（AUROC 0.93，截断值为1.50 mg/L时，敏感度和特异度分别为90.0%和86.5%）以及死亡发生风险（AUROC 0.84，截断值为3.39 mg/L时，敏感度和特异度分别为87.5%和80.0%）。
监测SFTS患者的凝血参数对判断患者病情的严重程度及死亡情况具有重要意义，对有重症风险的患者尽早关注、及时干预并最大程度降低死亡率具有重要临床价值。
