血清铁蛋白评估发热伴血小板减少综合征患者预后的预测价值  

Prognostic Value of Serum Ferritin in Patients with Severe Fever with Thrombocytopenia Syndrome

作　　者：汪玲妹 王成浩[1] 姚杰[1] 周强[1] WANG Ling-mei;WANG Cheng-hao;YAO Jie;ZHOU Qiang(Department of Clinical Laboratory,Second Affiliated Hospital of Anhui Medical University,Hefei,Anhui,230601,China)

机构地区：[1]安徽医科大学第二附属医院检验科,安徽合肥230601

出　　处：《中国血液流变学杂志》2024年第4期635-639,共5页Chinese Journal of Hemorheology

摘　　要：目的探讨血清铁蛋白(SF)评估发热伴血小板减少综合征(SFTS)患者预后的预测价值。方法纳入2023年1月—2024年6月安徽医科大学第二附属医院收治的126例SFTS患者,根据预后情况分为预后良好组(n=96)和预后不良组(n=30)。比较两组患者的基本信息及初次实验室检测指标,筛选影响预后的独立危险因素,采用受试者工作特征曲线(ROC曲线)分析SF评估SFTS患者预后的性能。结果预后不良组年龄及实验室指标白细胞计数(WBC)、中性粒细胞绝对值(N)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、D-二聚体(D-D)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、尿素氮(BUN)、肌酐(CREA)、淀粉酶(AMY)、脂肪酶(LPS)、肌酸激酶(CK)、肌酸激酶同工酶(CKMB)、乳酸脱氢酶(LDH)、高敏肌钙蛋白I(cTnI)、降钙素原(PCT)、SF均高于预后良好组,而血小板计数(PLT)、纤维蛋白原(FIB)、白蛋白(ALB)及血小板与淋巴细胞计数比值(PLR)均低于预后良好组,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示SF是评估SFTS患者预后的独立危险因素,评估预后不良的ROC曲线下面积为0.850(95%CI:0.763~0.938),当SF截断值为9248 ng/mL时,敏感性和特异性分别为76.7%和84.4%。结论SF在评估SFTS患者预后方面具有重要的临床价值。Objective To investigate the value of serum ferritin(SF)in evaluating the prognosis of severe fever with thrombocytopenia syndrome(SFTS).Methods 126 SFTS patients in Second Affiliated Hospital of Anhui Medical University from January 2023 to June 2024 were assigned into the good prognosis group(n=96)and the poor prognosis group(n=30)according to the prognosis.The basic data and just hospitalized laboratory indicators of the two groups were analyzed,the independent risk factors affecting the prognosis of SFTS were screened and SF on the prognosis of SFTS was evaluated by the area under the receiver-operating characteristic curve(ROC).Results Compared with the good prognosis group,the age and laboratory indicators including white blood cell count(WBC),neutrophil count(N),prothrombin time(PT),activated partial thromboplastin time(APTT),D-dimer(D-D),alanine aminotransferase(ALT),aspartate aminotransferase(AST),blood urea nitrogen(BUN),creatinine(CREA),amylase(AMY),lipase(LPS),creatine kinase(CK),creatine kinase isoenzyme(CKMB),lactate dehydrogenase(LDH),cardiac troponin I(cTnI),procalcitonin(PCT)and SF were higher in the poor prognosis group,but the laboratory indicators including platelet count(PLT),fibrinogen(FIB),albumin(ALB)and platelet-to-lymphocyte ratio(PLR)were lower(all P<0.05).SF was found to be an independent predictor of prognosis in the multifactorial logistic regression analysis.The area under the ROC curve for poor prognosis was 0.850(95%CI:0.763-0.938).When the cut-off value of SF was 9248 ng/mL,the sensitivity and specificity were 76.7%and 84.4%,respectively.Conclusion SF has an important clinical value in evaluating the prognosis of SFTS patients.

关 键 词：发热伴血小板减少综合征 铁蛋白 预后 

分 类 号：R446.11[医药卫生—诊断学] R512.99[医药卫生—临床医学]