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严重发热伴血小板减少综合征患者的预后预测

Prediction of Prognosis in Patients with Severe Fever with Thrombocytopenia Syndrome.

作者信息

Zhang Yi, Huang Lingtong, Shu Zheyue, Wu Wei, Cai Hongliu, Shi Yu

机构信息

Department of Laboratory Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, China.

Department of Critical Care Units, The First Affiliated Hospital, Zhejiang University School of Medicine, China.

出版信息

Jpn J Infect Dis. 2025 Jan 23;78(1):28-34. doi: 10.7883/yoken.JJID.2024.015. Epub 2024 Sep 30.

Abstract

This study aimed to understand the clinical characteristics of severe fever with thrombocytopenia syndrome (SFTS) and identify the risk factors for prognosis. In this retrospective study, we collected epidemiological, demographic, clinical, and laboratory data from 101 patients with SFTS. Patients were divided into survival and deceased groups, and a logistic regression model was used to evaluate the association between the predictors and prognostic variables. A joint detection factor model was constructed, and a receiver operating characteristic curve was drawn. A nomogram was established using the R language, and its efficiency in diagnosing SFTS was evaluated using a calibration curve. Patients in the deceased group were more likely to be older, have a shorter hospitalization stay, and have renal and multiple organ failure than those in the survival group. Statistically significant differences were observed in the neutrophil percentage, lymphocyte percentage, neutrophil-to-lymphocyte ratio, platelet (PLT) count, aspartate aminotransferase (AST)/alanine transaminase (ALT) ratio, AST, blood urea nitrogen, lactate dehydrogenase, hydroxybutyrate dehydrogenase, thromboplastin time, and activated partial thromboplastin time between the two groups. Lymphocyte percentage, PLT count, and the AST/ALT ratio were independent risk factors for mortality in patients with SFTS. Thus, we established a prediction model for SFTS mortality with good efficiency.

摘要

本研究旨在了解发热伴血小板减少综合征(SFTS)的临床特征,并确定预后的危险因素。在这项回顾性研究中,我们收集了101例SFTS患者的流行病学、人口统计学、临床和实验室数据。将患者分为存活组和死亡组,并使用逻辑回归模型评估预测因素与预后变量之间的关联。构建联合检测因子模型,并绘制受试者工作特征曲线。使用R语言建立列线图,并使用校准曲线评估其在诊断SFTS中的效率。与存活组患者相比,死亡组患者年龄更大、住院时间更短,且更容易出现肾衰竭和多器官衰竭。两组之间在中性粒细胞百分比、淋巴细胞百分比、中性粒细胞与淋巴细胞比值、血小板(PLT)计数、天冬氨酸转氨酶(AST)/丙氨酸转氨酶(ALT)比值、AST、血尿素氮、乳酸脱氢酶、羟丁酸脱氢酶、凝血酶原时间和活化部分凝血活酶时间方面观察到统计学上的显著差异。淋巴细胞百分比、PLT计数和AST/ALT比值是SFTS患者死亡的独立危险因素。因此,我们建立了一个效率良好的SFTS死亡率预测模型。

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