新型布尼亚病毒感染的临床特征及预后影响因素分析  

Clinical characteristics and prognostic factors of new bunia viral infection

作　　者：马于琪 梁明明 尹华发[1] MA Yuqi;LIANG Mingming;YIN Huafa(Department of Infectious Diseases,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,China)

机构地区：[1]安徽医科大学第一附属医院感染病科,合肥230022

出　　处：《实用医学杂志》2020年第23期3231-3236,共6页The Journal of Practical Medicine

基　　金：国家科技重大专项基金项目(编号:2018ZX10302⁃206)。

摘　　要：目的分析新型布尼亚病毒(SFTSV)致发热伴血小板减少综合征(SFTS)患者临床特征及预后影响因素,为早期诊治提供临床依据。方法收取2019年1月至2020年6月于安徽医科大学第一附属医院感染病科收治的80例SFTS确诊患者的病例资料,分为生存组(59例)与死亡组(21例),比较两组患者一般资料、症状体征、实验室指标、病毒载量等。实验室检测结果与预后的相关性采用Spearman相关分析。采用多因素二元logistic回归分析预后相关影响因素。结果生存组患者住院时间长于死亡组,差异有统计学意义(P<0.05);生存组eGFR1、Ca、PLT、CD4、CD8均高于死亡组,差异有统计学意义(P<0.05);生存组K、ALT、AST、ALP、GGT、LDH、CRE、CK、CKMB、空腹血糖、CRP、PCT、I1B、I6、I8、IL⁃10、IL⁃2R、TNA、APTT、TT、D⁃D、FDP、布尼亚病毒载量低于死亡组,差异有统计学意义(P<0.05)。结论神经系统表现(脑膜刺激征阳性或不同程度意识障碍)、APTT水平及病毒载量对数值可能是疾病预后的影响因素。Objective To explore the epidemiological characteristics and prognostic factors of fever and thrombocytopenia syndrome(SFTS)caused by new bunya virus(SFTSV),and provide clinical basis for early identification,diagnosis and treatment.Methods The case data of 80 SFTS patients admitted to the Department of Infectious Diseases,Anhui Medical University First Hospital from January 2019 to June 2020 were collected and divided into survival group(n=59)and death group(n=21).The two groups were compared in terms of general information,symptoms and signs,laboratory indicators and viral load.The correlation between laboratory test results and prognosis was analyzed by Spearman correlation analysis and prognostic related factors were analyzed with multivariate binary logistic regression.Results The length of stay in the survival group was statistically signif⁃icantly longer than that of the death group(P<0.05).The levels of eGFR1,Ca,PLT,CD4,and CD8 in the survival group were significantly higher than those in the death group(P<0.05).The levels of K,ALT,AST,ALP,GGT,LDH,CRE,CK,CKMB,fasting blood glucose,CRP,PCT,I1B,I6,I8,IL⁃10,IL⁃2R,TNA,APTT,TT,D⁃D,FDP and the viral load of Bunia virus in the survival group were all significantly lower than the death group(P<0.05).Conclusion Nervous system manifestations(positive meningeal stimulation sign or disturbance of consciousness at different degree),APTT level and the logarithm of viral load may be the factors influencing the prognosis of the disease.

关 键 词：发热伴血小板减少综合征 新型布尼亚病毒 临床特征 预后影响因素 

分 类 号：R512.8[医药卫生—内科学]