血钙水平对发热伴血小板减少综合征患者的预后评估价值  

Prognostic Value of Serum Calcium Levels in Severe Fever with Thrombocytopenia Syndrome

作　　者：臧艳[1] 李涛[1] 

机构地区：[1]安徽医科大学第一附属医院检验科,安徽 合肥

出　　处：《临床医学进展》2024年第5期133-141,共9页Advances in Clinical Medicine

摘　　要：目的:探讨血钙水平对发热伴血小板减少综合征(SFTS)患者预后的预测价值。方法:采用回顾性研究,收集于安徽医科大学第一附属医院住院治疗的181例SFTS患者的临床资料,根据临床结局分为死亡组(44例)和存活组(137例),对比分析两组患者的年龄及各项实验室检测指标。采用单因素及多因素COX回归分析不良结局的独立危险因素,通过ROC曲线和Kaplan-Meier生存分析评估血钙水平对SFTS患者临床结局的预测能力。结果:与存活组相比,死亡组患者的APTT、PT、D-D、Cr、BUN、ALT、AST、CK-MB、LDH、钾、CRP、IL-6、IL-8、IL-10水平显著升高(P < 0.05);而PLT、L、M、Fib、GFR、钙和碳酸氢根水平则显著降低(P < 0.05)。年龄(HR = 1.875, 95%CI: 1.120~3.138, P = 0.017)和IL-10 (HR = 1.004, 95%CI: 1.002~1.006, P < 0.001)是患者死亡的独立危险因素;而血钙水平(HR = 0.022, 95%CI: 0.001~0.480, P = 0.015)是独立保护因素。结论:血清钙离子水平对早期评估SFTS患者临床预后具有重要价值,可为病情评估和临床诊疗提供重要参考信息。Objective: To investigate the value of serum calcium levels in predicting the prognosis of patients with severe fever with thrombocytopenia syndrome (SFTS). Methods: A retrospective study was conducted to collect clinical data from 181 patients diagnosed with Severe Fever with Thrombocytopenia Syndrome (SFTS) and admitted to the First Affiliated Hospital of Anhui Medical University. Patients were classified into two groups based on clinical outcomes: the death group (44 cases) and the survival group (137 cases). Comparative analysis was performed on the age and laboratory markers of these two patient groups. Univariate and multivariate Cox regression analyses were utilized to explore in-dependent risk factors for adverse outcomes, while ROC curve and Kaplan-Meier survival analysis were employed to evaluate the predictive ability of blood calcium levels on clinical outcomes in patients with SFTS. Results: Compared to the survival group, deceased patients showed significantly elevated levels of APTT, PT, D-D, Cr, BUN, ALT, AST, CK-MB, LDH, potassium, CRP, IL-6, IL-8, and IL-10 (P < 0.05). Conversely, PLT, L, M, Fib, GFR, calcium, and bicarbonate levels were significantly decreased (P < 0.05). Furthermore, age (HR = 1.875, 95%CI: 1.120~3.138, P = 0.017) and IL-10 (HR = 1.004, 95%CI: 1.002~1.006, P < 0.001) emerged as independent risk factors for patient mortality, while blood calcium level (HR = 0.022, 95%CI: 0.001~0.480, P = 0.015) was identified as an independent protective factor. Conclusion: Serum calcium levels are crucial for early prognosis evaluation in SFTS patients, offering vital insights for diagnosis and treatment planning.

关 键 词：发热伴血小板减少综合征 血钙水平 预后 

分 类 号：R73[医药卫生—肿瘤]