轻症与重症新型布尼亚病毒感染临床和实验室指标差异分析  

Analysis of clinical and laboratory indexes between mild and severe infection of novel bunyavirus

作　　者：叶重阳 张荣荣 梅清 朱春艳 陈婷[2] YE Chongyang;ZHANG Rongrong;MEI Qing;ZHU Chunyan;CHEN Ting(Department of Critical Care Mediceine,The First Affiliated Hospital of USTC,HeFei Anhui 230009,China)

机构地区：[1]中国科技大学附属第一医院安徽省立医院重症医学科,安徽合肥230009 [2]合肥市第二人民医院重症医学科,安徽合肥230032

出　　处：《中国急救复苏与灾害医学杂志》2020年第7期847-849,共3页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：国家临床重点专科建设项日(编号:2011-1563)。

摘　　要：目的分析新型布尼亚病毒(novelbunyavirus,NBV)感染致发热伴血小板减少综合征(severefeverwith thrombocytopenia syndrome,SFTS)轻症与重症患者临床和实验室指标差异。方法选择中国科技大学附属第一医院2018年1月--2019年9月经实验室确证的47例SFTS患者,按中国原卫生部2010SFTS防治指南分为两组:轻症组24例,重症组23例。收集两组临床资料和实验室指标。结果轻症组与重症组在年龄、性别、最高体温(Tm)、高血压病和糖尿病等既往史以及消化道症状发生率的差异无统计学意义(P>0.05)。轻症组与重症组在神经系统症状、体温超过37.5℃时间(Tc).白细胞最低值(WBClow).白细胞计数少于4×10^9/L持续时间(WBCc)、血小板计数少于100×10^9/L持续时间(PLTJ)、ALT、AST、APTT、CD4T差异有统计学意义(P<0.05)。进一步多因素logistic回归发现,WBClow、WBCe、PLTc、APTT、CD4+T是重症组的高危因素。结论卫生部2010SFTS防治指南的重症指标是血小板计数少于30×10^/L,即使据此归为轻症组者,如有神经系统症状、WBClow、WBCc、PLTC、APTT、CD4+T可能也需要按重症管理。Objective To analyze the difference of clinical and laboratory indexes between mild and severe cases of fever with thrombocytopenia syndrome(SFTS)caused by infection of novel bunyavirus(NBV),so as to provide better treatment decisions for elinical practice.Methods 47 cases of SFTS confirmed by the laboratory from January 1,2018 to September 30,2019 in The First Afiliated Hospital of USTC were divided into two groups according to the guidance of Ministry of health 2010 SFTS:24 cases of mild disease group and 23 cases of severe disease group.Clinical and laboratory data of the lwo groups were ollcted.Results There was no significant diference between the mild group and the severe group in the past medical history of hypertension and diabetes,age,gender,the highest body temperature,and the incidence of gastrointestinal symptoms(P>0.05).The symptoms of nervous system,the time of body temperalture over 37.5℃,the minimum value of leukocyte,the duration of leukocyte less than 4×10^/L,the duration of the platelet less than 100×10^/L,ALT,AST,APTT and CD4+T were signifcantly diferent between the mild group and the severe group(P<0.05).Multivariate logistic regression showed that WBClow,WBC,PLT、APTT and CD4+T were the high risk factors in the severe group.Conclusion The guideline of the Ministry of health 2010 SFTS for severe cases is that platelet count is less than 30×10^/L,even if it is divided into mild cases,if there are neurological symptoms,WBClow,W BC,PLTe,APTT,CD4T,it may also need to be managed according to severe cases.

关 键 词：新型布尼亚病毒 发热伴血小板减少综合征 分析 轻症 重症 

分 类 号：R41[医药卫生—临床医学]