严重发热伴血小板减少综合征中糖皮质激素的使用：一项回顾性队列研究。

The use of glucocorticoid in severe fever with thrombocytopenia syndrome: a retrospective cohort study.

机构信息

Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.

Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.

出版信息

Front Cell Infect Microbiol. 2024 Aug 6;14:1419015. doi: 10.3389/fcimb.2024.1419015. eCollection 2024.

INTRODUCTION

Severe fever with thrombocytopenia syndrome (SFTS) is prevalent in East Asia. However, the use of glucocorticoids (GCs) in the treatment of SFTS remains controversial.

METHODS

In this retrospective cohort study, we collected the data from patients with SFTS at Wuhan Union Hospital to evaluate the effect of GC therapy. Mortality and secondary infections were compared as outcomes. After searching public databases, we also included articles that examined GC use in patients with SFTS for meta-analysis.

RESULTS

Patients treated with GC had higher fatality rates (21.1% vs. 11.9%, respectively; =0.006) and a longer length of stay (10.6 ± 5.1 vs. 9.5 ± 4.2, respectively; =0.033). In cohorts adjusted using propensity score matching and inverse probability of treatment weighting, no significant differences in fatality rates and length of stay were observed. A meta-analysis of 4243 SFTS patient revealed that those treated with GCs had significantly higher mortality (OR=3.46, 95% CI =2.12-5.64, <0.00001) and secondary infection rate (OR=1.97, 95% CI=1.45-2.67, <0.0001).

DISCUSSION

GC should be used cautiously when treating SFTS. No significant differences were identified in terms of mortality and secondary infection rates between patients with SFTS treated with or without GC.

简介

严重发热伴血小板减少综合征（SFTS）在东亚地区较为流行。然而，糖皮质激素（GCs）在 SFTS 治疗中的应用仍存在争议。

方法

本回顾性队列研究收集了武汉协和医院 SFTS 患者的数据，以评估 GC 治疗的效果。将死亡率和继发感染作为结局进行比较。检索公共数据库后，我们还纳入了评估 GC 在 SFTS 患者中应用的文章进行荟萃分析。

结果

GC 治疗组的死亡率更高（21.1% vs. 11.9%，=0.006），住院时间更长（10.6±5.1 vs. 9.5±4.2，=0.033）。在使用倾向评分匹配和逆概率处理加权调整的队列中，死亡率和住院时间无显著差异。对 4243 例 SFTS 患者的荟萃分析显示，GC 治疗组的死亡率（OR=3.46，95%CI=2.12-5.64，<0.00001）和继发感染率（OR=1.97，95%CI=1.45-2.67，<0.0001）显著升高。