Clinical Characteristics Of Tsutsugamushi Disease And Analysis Of Related Factors Of Severe Tsutsugamushi Disease In The Border Area Of Guangxi,Yunnan And Guizhou

Objective: To analyze and discuss the clinical characteristics and related factors of tsutsugamushi disease in the border area of Guangxi,Yunnan and Guizhou,and to provide basis for the prevention,diagnosis,treatment and diagnosis of tsutsugamushi disease.Methods:The basic data,clinical manifestations,auxiliary examinations and imaging findings of 394 patients admitted to The Affiliated Hospital of Youjiang Medical College for Nationalities from December 2018 to December 2021 who were diagnosed with scrub typhus were retrospectively analyzed.The patients were divided into the critical group and the non-critical group according to whether there was serious organ function damage or shock.Then,descriptive statistics and Logistics regression were used to analyze the clinical characteristics of tsutsugamushi patients and the related factors of severe tsutsugamushi disease.Results:(1)Tsutsugamushi disease occurred in the border area of Guangxi,Yunnan and Guizhou all year round,and the incidence rate was higher in 6-9 months.(2)386 patients(97.97%)had fever,and the patients in both groups were mainly high fever;(3)Eschar / ulcer/ rash occurred in 321 patients(81.47%)with tsutsugamushi disease;(4)292 patients had myocardial damage and 291 patients had liver function damage;(5)The positive rate of waifei test meeting the diagnostic criteria was low,only 128 cases(32.49%);(6)There were differences in age,WBC,N%,PLT,PCT,CRP,Cr,AST,TBIL,LDH,CK-MB and CK between the two groups(P < 0.05),but there were no differences in gender,eosinophil count,fever,waifei test results,ALT and HCT between the two groups(P > 0.05);(7)Multivariate logistic analysis showed that age(OR: 1.039;95% CI 1.005 ～ 1.073),PCT(OR: 1.026;95%CI 1.002 ～ 1.050),CRP(OR: 1.007;95% CI 1.001 ～ 1.013),CK-MB(OR: 1.022;95% CI1.010 ～ 1.035),LDH(OR: 1.002;95% CI 1.001 ～ 1.003);(8)ROC curve analysis showed that age,PCT,CRP,LDH and CK-MB had the highest AUC.Conclusion:(1)This study found that tsutsugamushi occurred all year round in the border area of Guangxi,Yunnan and Guizhou,and patients aged 40-60 years were most prevalent in mountainous areas,summer and autumn.(2)Fever is the main clinical manifestation of tsutsugamushi disease patients,usually accompanied by myocardium damage mainly organ function damage;(3)The results of external testing can not predict the severity of disease;(4)Age,WBC,N%,PLT,PCT,CRP,Cr,AST,TBil,LDH,CK-MB and CK of scrub typhus patients may be correlated with the severity of scrub typhus.Age,PCT,CRP,LDH and CK-MB were independent risk factors for the severity of scrub typhus,and combined use could better identify patients with severe disease earlier.