摘要
目的回顾新型布尼亚病毒感染致发热伴血小板减少综合征(severe fever with thrombocytopenia syndrome,SFTS)患者入院时的血常规及凝血功能,分析其异常原因,探讨疾病预后指标。方法回顾性分析2023年4月1日—2023年11月30日医院收治的120例SFTS患者,根据患者的预后情况,分为存活组(n=69)和死亡组(n=51)。比较2组患者入院时的一般资料和24 h内首次检查的血常规:白细胞计数(WBC)、中性粒细胞绝对值(NEU#)、淋巴细胞绝对值(LYM#)、中性淋巴细胞比值(NLR)、红细胞(RBC)、血红蛋白(HGB)、血小板计数(PLT)及凝血功能:凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血酶时间(APTT)、纤维蛋白原(FIB)及D-二聚体(D-D)指标的差异。结果2组患者性别、WBC、NEU#、LYM#、NLR、RBC、HGB比较差异无统计学意义(P>0.05);与存活组比较,死亡组的PLT、FIB显著降低,年龄、APTT、PT、TT、D-D显著升高,差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示,入院时年龄、APTT、D-D是SFTS患者预后的独立危险因素(P<0.05)。ROC曲线分析显示年龄、APTT和D-D联合检测的曲线下面积为0.804(95%CI 0.729~0.878),其灵敏度、特异度分别为64.3%、82.7%。结论SFTS患者血常规及凝血功能异常发生率较高,年龄、APTT、D-D水平有可能成为SFTS患者预后判断的指标之一。
Objective To evaluate the blood routine and coagulation function of the patients with febrile thrombocytopenia syndrome(SFTS)at admission,analyze the causes of abnormalities,and explore potential prognostic indicators.Methods A retrospective analysis was carried out on 120 SFTS patients admitted to our hospital from April 1,2023,to November 30,2023.According to the prognosis,the patients were divided into a survival group and a death group.The differences in general information,blood routine and coagulation indicators between the two groups of patients at admission were compared.The blood routine parameters included white blood cell(WBC),absolute neutrophil count(NEU#),absolute lymphocyte count(LYM#),neutrophil-lymphocyte ratio(NLR),red blood cell(RBC),hemoglobin(HGB)and platelet count(PLT).The coagulation indicators included prothrombin time(PT),thrombin time(TT),activated partial thromboplastin time(APTT),fibrinogen(FIB)and D-Dimer(D-D).Results There were no significant differences in gender or various blood parameters between the two patient groups.However,compared with the survival group,the death group had a remarkable decrease in PLT and FIB levels,while APTT,PT,TT and D-D levels increased significantly.Multivariate logistic regression analysis indicated that the age at admission,APTT and D-D levels were independent risk factors for the prognosis of SFTS.The ROC curve analysis demonstrated that the area under the curve for predicting the risk of death and the severity of SFTS based on the combination of age,APTT and D-D was 0.804(95%CI 0.729-0.878),with a sensitivity of 64.3%and a specificity of 82.7%.Conclusion The incidence of abnormal hematological and coagulation function in SFTS patients was high.Age,APTT and D-D levels may be used as potential prognostic indicators for SFTS.
作者
向旭
戴跃青
李德磊
李松
XIANG Xu;DAI Yueqing;LI Delei;LI Song(Department of Laboratory,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,430030,China;Department of Gastroenterology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology)
出处
《临床血液学杂志》
2025年第4期269-273,共5页
Journal of Clinical Hematology
