Zhang Ruihua, Mu Yameng, Zhang Mengyuan, Wu Hongxiao, Xu Yanli, Zhao Chenxi, Liu Zishuai, Lin Ling, Zhang Wei, Kong Yaxian, Chen Zhihai
National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China.
Department of Infectious Disease, Beijing Ditan Hospital, Capital Medical University, Beijing, China.
J Med Virol. 2025 Jun;97(6):e70428. doi: 10.1002/jmv.70428.
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease with significant mortality risks. This study evaluated the predictive value of the lactate dehydrogenase/albumin to urea ratio (LAU) for lethal outcomes in SFTS patients. Clinical data from 348 patients (295 survivors, 53 non-survivors) admitted to Yantai Infectious Disease Hospital (2022-2023) were analyzed. Multivariate analysis identified older age, SFTS-associated encephalopathy, SFTSV RNA, decreased albumin and serum calcium, increased lactate dehydrogenase, and elevated LAU as independent mortality risk factors. LAU demonstrated strong predictive accuracy (AUC: 0.79; 95% CI: 0.72-0.85; sensitivity 69%, specificity 75%), with an optimal cutoff of 144.685 U·mmol/g·L. Survival analysis linked high LAU to poor prognosis, and longitudinal trends showed decreasing LAU with recovery in survivors but rising levels in non-survivors. These findings highlight LAU as a novel, practical biomarker for early risk stratification and prognosis improvement in SFTS.
重症发热伴血小板减少综合征（SFTS）是一种新出现的具有重大死亡风险的传染病。本研究评估了乳酸脱氢酶/白蛋白与尿素比值（LAU）对SFTS患者致死结局的预测价值。分析了烟台传染病医院（2022 - 2023年）收治的348例患者（295例幸存者，53例非幸存者）的临床资料。多因素分析确定年龄较大、SFTS相关脑病、SFTSV RNA、白蛋白和血清钙降低、乳酸脱氢酶升高以及LAU升高为独立的死亡风险因素。LAU显示出较强的预测准确性（曲线下面积：0.79；95%置信区间：0.72 - 0.85；敏感性69%，特异性75%），最佳截断值为144.685 U·mmol/g·L。生存分析表明高LAU与预后不良相关，纵向趋势显示幸存者LAU随恢复而降低，而非幸存者则升高。这些发现突出了LAU作为一种用于SFTS早期风险分层和改善预后的新型实用生物标志物的作用。
