发热伴血小板减少综合征流行病学特点与临床特征分析

发布时间：2018-01-28 17:17

本文关键词： 发热伴血小板减少综合征布尼亚病毒感染危险因素流行病学　出处：《中国病原生物学杂志》2017年09期 　论文类型：期刊论文

【摘要】：目的探讨发热伴血小板减少综合征流行病学和病原学特点及临床和影像学特征,为该病的综合防治提供参考依据。方法 2012年1月至2017年1月枣庄市报告的发热伴血小板减少综合征患者149例,采用流行病学个案调查表对病例进行回归性分析,内容包括患者一般临床特征、实验室检查资料,肺与颅脑CT影像学资料分析等。采用Logistic回归分析筛查重症组患者发生的危险因素。结果 149例发热伴血小板减少患者中,未明确病因74例,人粒细胞无形体病感染2例,新布尼亚病毒感染73例。所有病例均为散发,无聚集倾向。轻症组布尼亚病毒感染47例,重症组布尼亚病毒感染26例。患者职业以农民为主,占84.56%(126/149)。发病前半月内有野外作业史占72.48%(108/149)。发病时间以每年的4-11月份多见,发病高峰在5、6、9和10月份。布尼亚病毒感染因素包括年龄(P0.01),糖尿病(P0.01),高血压病(P0.05),冠心病(P0.05),布尼亚病毒核酸(P0.01)、血清降钙素原(P0.01),CD4+CD25+T淋巴细胞比值(P0.01)和血小板水平(P0.05)。重症组患者肺部感染发生率100%,颅内多发低密度灶8例,病灶分布以多叶分布为主。经多因素非条件Logistic回归分析,发热伴血小板减少综合征患者新布尼亚病毒感染危险因素为:年龄(OR=1.654,P0.01),糖尿病(OR=1.892,P0.01),冠心病(OR=1.316,P0.01),野外作业史(OR=2.464,P0.01),蜱虫叮咬史(OR=2.905,P0.01)。结论发热伴血小板减少综合征的发生呈季节性分布,年龄、糖尿病、冠心病、野外作业及蜱虫叮咬为新布尼亚病毒感染危险因素,可为该病的防治提供参考。
[Abstract]:Objective to investigate the epidemiological and etiological characteristics and clinical and imaging features of fever with thrombocytopenia syndrome. Methods from January 2012 to January 2017, 149 cases of fever with thrombocytopenia syndrome were reported in Zaozhuang city. The epidemiological case questionnaire was used to carry on the regression analysis to the case, including the general clinical characteristic of the patient, the laboratory examination data. Logistic regression analysis was used to screen the risk factors in severe patients. Results in 149 patients with fever and thrombocytopenia. There were 74 cases of unknown etiology, 2 cases of human granulocytic disease and 73 cases of new Bunia virus infection. All the cases were sporadic and had no tendency to gather. In mild group, 47 cases were infected with Bunia virus. There were 26 cases of Bunia virus infection in the severe group. The occupation of the patients was mainly farmers. Accounting for 84.56 / 126 / 149. In the first half month before the onset of the disease, there was a history of field work, accounting for 72.48 / 108 / 149. The onset time was more frequent in April-November of each year, and the peak incidence was at 5. 6 / 9 and October. The infection factors of Bunia virus included age, diabetes mellitus, hypertension and coronary heart disease. Bunia virus nucleic acid (P0.01) and serum procalcitonin (P0.01). CD4 CD25 T lymphocyte ratio (P0.01) and platelet level P0.050.The incidence of pulmonary infection was 100 in the severe group and 8 patients had multiple intracranial low-density foci. The distribution of lesions was mainly multilobular and multivariate conditional Logistic regression analysis was used. The risk factors of neobonia virus infection in patients with fever and thrombocytopenia syndrome were: the age of ORV was 1.654% (P0.01), and that of diabetes mellitus was 1.892g / P0.01). Coronary heart disease (CHD) was 1.316m (P0.01A), field work was (2.464) (P0.01A) and ticks bite was (2.905). Conclusion the incidence of fever with thrombocytopenia syndrome is seasonal, age, diabetes, coronary heart disease, field work and ticks bite are risk factors of neobonia virus infection. It can provide reference for the prevention and cure of the disease.
【作者单位】：枣庄市薛城区人民医院;
【分类号】：R181.3;R510
【正文快照】： 发热伴血小板减少综合征是临床出现发热症状同时伴有血小板减少为主要特征的一系列临床综合征。多数患者伴血清肌酶升高或轻度消化系统症状。严重者可伴多脏器功能损伤,以凝血机制异常、肝酶升高为主,部分患者病情可进展迅速,伴心力衰竭以及神志改变,出现多脏器功能衰竭,临床

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