2018-2022年山东省潍坊市某医院发热伴血小板减少综合征患者神经系统受累临床危险因素研究  

Clinical risk factors of neurological involvement in severe fever with thrombocytopenia syndrome patients in a hospital in Weifang city,Shandong province,2018−2022

作　　者：张美刚 赵娜娜 吴翠萍 Zhang Meigang;Zhao Nana;Wu Cuiping(Department of Clinical Medicine,Weifang Medical University,Weifang 261053,Shandong,China;Department of Infection,Weifang Yidu Central Hospital,Weifang 262500,Shandong,China)

机构地区：[1]潍坊医学院临床医学院,潍坊医学院,山东潍坊261053 [2]潍坊市益都中心医院感染科,山东潍坊262500

出　　处：《疾病监测》2024年第7期929-933,共5页Disease Surveillance

摘　　要：目的探讨影响发热伴血小板减少综合症(SFTS)患者神经系统受累的危险因素。方法选取2018—2022年山东省潍坊市益都中心医院收治的SFTS患者。分析两组患者临床资料及实验室检查,并对影响神经系统受累的危险因素进行logistic回归分析。结果106例患者分为单纯SFTS组(对照组,51例)和神经系统受累组(实验组,55例),实验组发热≥38.5℃、年龄≥65岁、尿蛋白≥2+、恶心呕吐方面的例数明显多于对照组(χ^(2)=21.668、3.883、18.603、7.338,P<0.05);实验组血小板计数平均值低于对照组(t=6.770,P<0.001);实验组丙氨酸氨基转移酶、天冬氨酸氨基转移酶、肌酸激酶、肌酸激酶同工酶、乳酸脱氢酶、降钙素原等较对照组明显升高,且两组之间的差异有统计学意义(Z=−1.970、−3.614、−3.048、−3.386、−4.091、−2.586,P<0.05)。logistic回归分析结果显示:年龄≥65岁、尿蛋白≥2+及低水平的PLT是SFTS患者神经系统受累的独立危险因素。年龄≥65岁,神经系统受累风险增加4.32倍;尿蛋白≥2+,神经系统受累的风险增加5.32倍;PLT每升高1个单位(1×10^(9)/L),神经系统受累的风险就降低6.00%。结论年龄≥65岁、尿蛋白≥2+、血小板是SFTS患者神经系统受累的独立临床危险因素。因此,临床工作中应注意筛查上述指标,指导临床诊疗。Objective To study the risk factors of neurological involvement in severe fever with thrombocytopenia syndrome(SFTS)patients.Methods Patients admitted to Weifang Yidu Central Hospital from 2018 to 2022 were selected.The clinical data and laboratory test of the 2 groups were analyzed,and the risk factors of neurological involvement were analyzed by logistic regression analysis.Results A total of 106 patients were selected,simple group(control group,51 patients)and neurological involvement group(experimental group,55 patients).The cases of fever≥38.5℃,age≥65 years old,urinary protein≥2+,nausea and vomiting in the experimental group were significantly more than those in the control group(χ^(2)=3.883,21.668,18.603,7.338,P=0.049<0.05).The average value of platelet count in the experimental group was lower than that in the control group(t=6.770,P<0.001);Alanine transaminase,Aspartate transaminase,Procalcitonin,Lactate dehydrogenase,Creatine kinase and Creatine kinase MB in the experimental group were higher than those in the control group and the difference between the two groups is statistically significant(Z=−1.970,−3.614,−3.048,−3.386,−4.091,−2.586;P=0.049,<0.001,0.010,<0.001,0.002,<0.001).logistic regression analysis showed that age≥65 years old,urinary protein≥2+and low level of PLT were independent risk factors for neurological involvement in patients with SFTS.The risk of neurological involvement increased by 4.32 times after age≥65 years old;the risk of neurological involvement increased by 5.32 times after urinary protein≥2+;for every unit(1×10/L)of increase in PLT,the risk of neurological involvement decreased by 6.00%,that means PLT is a protective factor.Conclusion Aged≥65 years old,urinary protein≥2+and low level of PLT were independent clinical risk factors for neurological involvement in patients with SFTS.Therefore,attention should be paid to screening the above-mentioned indexes in clinical work.

关 键 词：危重疾病 发热伴血小板减少综合征 神经系统受累 独立临床危险因素 

分 类 号：R211[医药卫生—中医学] R373.3