国际流行病学传染病学杂志
國際流行病學傳染病學雜誌
국제류행병학전염병학잡지
INTERNATIONAL JOURNAL OF EPIDEMIOLOGY AND INFECTIOUS DISEASE
2015年
2期
115-119
,共5页
杨振东%秦书理%赵普宇%王炳军%汤芳%陈四喜%黄茂林%龚璐璐%范雪娟
楊振東%秦書理%趙普宇%王炳軍%湯芳%陳四喜%黃茂林%龔璐璐%範雪娟
양진동%진서리%조보우%왕병군%탕방%진사희%황무림%공로로%범설연
布尼亚病毒科感染%发热伴血小板减少综合征%危险因素
佈尼亞病毒科感染%髮熱伴血小闆減少綜閤徵%危險因素
포니아병독과감염%발열반혈소판감소종합정%위험인소
Bunyavirus infections%Severe fever with thrombocytopenia syndrome%Risk factor
目的 分析发热伴血小板减少综合征(SFTS)患者的临床特征和危险因素.方法 收集2011年5月至2012年7月解放军第一五四医院就诊的273例SFTS患者的相关信息,采用RT-PCR检测新布尼亚病毒(SFTSV),通过ELISA检测SFTSV-IgM和IgG抗体,采用Human BioPlex ProTM Assays 17-Plex Panel方法测定细胞因子.对确诊病例采用单因素、多因素Logistic回归模型分析SFTS病例重症和死亡发生的危险因素.结果 273例SFTS患者中180例SFTSV核酸阳性.主要临床表现为发热、乏力、肌肉酸痛和胃肠道症状.多因素Logistic分析显示,年龄≥60岁(OR=1.08,95％CI:1.03～1.13)、淋巴结肿大(OR =3.75,95％CI:1.45～9.66)、下呼吸道感染(OR=3.57,95％CI:1.40～9.11)、肌酐(Cr)＞97 mmol/L(OR=4.10,95％CI:1.55～10.82)及意识障碍(OR=3.35,95％CI:1.21～9.29)与重症病例发生显著相关.年龄≥60岁(OR=1.06,95％CI:1.00～1.12),下呼吸道感染(OR=4.33,95％CI:1.35～13.93),Cr＞97 mmol/L (OR=10.14,95％CI:3.19～32.21)及意识障碍(OR=3.47,95％CI:1.03～11.72)与死亡病例发生显著相关.结论 年龄≥60岁、合并下呼吸道感染、Cr＞97 mmol/L、意识障碍是SFTS患者预后不良的危险因素,应予重点治疗.
目的 分析髮熱伴血小闆減少綜閤徵(SFTS)患者的臨床特徵和危險因素.方法 收集2011年5月至2012年7月解放軍第一五四醫院就診的273例SFTS患者的相關信息,採用RT-PCR檢測新佈尼亞病毒(SFTSV),通過ELISA檢測SFTSV-IgM和IgG抗體,採用Human BioPlex ProTM Assays 17-Plex Panel方法測定細胞因子.對確診病例採用單因素、多因素Logistic迴歸模型分析SFTS病例重癥和死亡髮生的危險因素.結果 273例SFTS患者中180例SFTSV覈痠暘性.主要臨床錶現為髮熱、乏力、肌肉痠痛和胃腸道癥狀.多因素Logistic分析顯示,年齡≥60歲(OR=1.08,95％CI:1.03～1.13)、淋巴結腫大(OR =3.75,95％CI:1.45～9.66)、下呼吸道感染(OR=3.57,95％CI:1.40～9.11)、肌酐(Cr)＞97 mmol/L(OR=4.10,95％CI:1.55～10.82)及意識障礙(OR=3.35,95％CI:1.21～9.29)與重癥病例髮生顯著相關.年齡≥60歲(OR=1.06,95％CI:1.00～1.12),下呼吸道感染(OR=4.33,95％CI:1.35～13.93),Cr＞97 mmol/L (OR=10.14,95％CI:3.19～32.21)及意識障礙(OR=3.47,95％CI:1.03～11.72)與死亡病例髮生顯著相關.結論 年齡≥60歲、閤併下呼吸道感染、Cr＞97 mmol/L、意識障礙是SFTS患者預後不良的危險因素,應予重點治療.
목적 분석발열반혈소판감소종합정(SFTS)환자적림상특정화위험인소.방법 수집2011년5월지2012년7월해방군제일오사의원취진적273례SFTS환자적상관신식,채용RT-PCR검측신포니아병독(SFTSV),통과ELISA검측SFTSV-IgM화IgG항체,채용Human BioPlex ProTM Assays 17-Plex Panel방법측정세포인자.대학진병례채용단인소、다인소Logistic회귀모형분석SFTS병례중증화사망발생적위험인소.결과 273례SFTS환자중180례SFTSV핵산양성.주요림상표현위발열、핍력、기육산통화위장도증상.다인소Logistic분석현시,년령≥60세(OR=1.08,95％CI:1.03～1.13)、림파결종대(OR =3.75,95％CI:1.45～9.66)、하호흡도감염(OR=3.57,95％CI:1.40～9.11)、기항(Cr)＞97 mmol/L(OR=4.10,95％CI:1.55～10.82)급의식장애(OR=3.35,95％CI:1.21～9.29)여중증병례발생현저상관.년령≥60세(OR=1.06,95％CI:1.00～1.12),하호흡도감염(OR=4.33,95％CI:1.35～13.93),Cr＞97 mmol/L (OR=10.14,95％CI:3.19～32.21)급의식장애(OR=3.47,95％CI:1.03～11.72)여사망병례발생현저상관.결론 년령≥60세、합병하호흡도감염、Cr＞97 mmol/L、의식장애시SFTS환자예후불량적위험인소,응여중점치료.
Objective To analyze the clinical characteristics and risk factors of severe fever with thrombocytopenia syndrome (SFTS).Methods The data of 273 SFTS patients admitted to the 154th Hospital of People's Liberation Army from May 2011 to July 2012 were analyzed.Severe fever with thrombocytopenia syndrome bunyavirus (SFTSV) was detected by RT-PCR,SFTSV-IgM,and SFTSV-IgG were detected by ELISA,and cytokines was detected by Human BioPlex ProTM Assays 17-Plex Panel method.The risk factors for SFTS severe cases and deaths occurred were analyzed by singal factor and multi-factor logistic regression method.Results A total of 180 laboratory-confirmed SFTSV positive cases among 273 SFTS patients were included in the study,with clinical presentations of fever,weakness,myalgia and gastrointestinal symptoms.The multi-factor logistic analysis showed that there were significant correlations between severe cases and age ≥60 (OR=1.08,95％ CI:1.03-1.13),lymphadenectasis (OR =3.75,95％ CI:1.45-9.66),lower respiratory tract infection (OR =3.57,95％CI:1.40-9.11),creatinine(Cr)＞97 mmol/L (OR =4.10,95％CI:1.55-10.82) and consciousness disorder (OR=3.35,95％CI:1.21-9.29).There were significant correlations between death cases and age ≥60 (OR=1.06,95％ CI:1.00-1.12),lower respiratory tract infection (OR=4.33,95％CI:1.35-13.93),Cr＞97 mmol/L(OR=10.14,95％ CI:3.19-32.21) and consciousness disorder (OR=3.47,95％CI:1.03-11.72).Conclusions Older age(≥60),pulmonary infection,Cr＞97 mmol/L,impairment on renal function and nervous system are the most notable risk factors.
