Application Of Medical Trioxygen In Severe Fever With Thrombocytopenia Syndrome

Objective:To clarify the trend of major laboratory tests in patients with severe fever and thrombocytopenia syndrome(SFTS)admitted to the Department of Infectious Diseases of the6 th People's Hospital of Qingdao,and to conduct a prospective randomized controlled trial on the application of medical trioxygen in patients with SFTS.The safety of medical trioxygen,the impact on the main laboratory test indicators,and the impact on patient survival in the acute phase were to be investigated.Methods:1.Main laboratory test indicators of SFTS patients admitted to 6th People's Hospital of Qingdao from Jan 2016 to Dec 2017 were collected: WBC count,platelets,monocytes,liver function,myocardial enzymes Spectrum,renal function,coagulation function,serum amylase.GraphPad Prism 6.0 was used to make trend graph.2.Patients who were diagnosed as SFTS from January to Dember in 2018 in the Department of Infectious Diseases of the 6th People's Hospital of Qingdao were enrolled and randomly divided into control group and medical trioxygen group.Basic information of the patients was recorded and relevant inspections were completed on the day of enrollment.Supportive treatment was given in both groups,and trioxygen group received trioxygen autologous blood transfusion treatment two times.Main laboratory inspections were carried out in both groups the next day after trioxygen treatment,and statistical analysis was made between corresponding parameters.Survival data of patients was compared by using Kaplan-Meier survival analysis.Results:1.In 1st part of our research,44 cases were enrolled.The median WBC and monocyte counts of the patients reached the lowest value on the 6th day of the disease course,and the median platelet count reached the lowest value on the 8th day of the disease course;The median CK,CKMB,and LDH of the patient's myocardial enzymes reached the highest value on the 8th,9th,and 8th day of the disease course,respectively;The median BUN and CREA of renal function were maintained at a low level throughout the course of the disease,and nosevere renal insufficiency was found in all enrolled patients;There were a total of 10 cases of patients with elevated serum amylase,the median serum amylase began to increase gradually on the 6-8th day of the disease,and slowly decreased after reaching the highest value on the 10 th day of the disease course;The median PT of the patients did not significantly prolong,but APTT was prolonged in the course of disease,the highest value was reached on the 10 th day.2.In 2nd part of our research,61 cases were enrolled,which were divided randomly into control group and medical trioxygen group.Most common adverse reactions of 15ug/ml medical trioxygen autologous blood transfusion treatment were aching and bleeding at the puncture site(70%,21/30),followed by mild dizziness,nausea,which accounted for(50%,15/30),transient blood pressure decrease in 3 cases(10%),2 patients had subcutaneous hematoma(6.7%).After medical trioxygen treatment,there was statistical significance in ALT,APTT,CD4+ cell count,and IL-6 between the two groups.There was no statistical difference in mortality rate between the two groups(Fisher's exact test,P=0.081).According to Log-Rank test,there was statistically significant difference in survival data between the two groups(x~2=4.364,P=0.0367).Conclusion:1.Amomg patients with SFTS admitted to the 6th People's Hospital of Qingdao City,the laboratory test parameters of patients within 1 week of onset were mainly the decrease of WBC and monocytes.The abnormal clinical test parameters of patients 8-9 days after onset were mainly tissues and organs damages(liver,heart,coagulation function,pancreas,and platelet).Attention should be paid to the protection of the corresponding organs and symptomatic treatment to promote the recovery of the patient's condition in different phases.2.Medical trioxygen autologous blood transfusion treatment of 15ug/ml is relatively safe in patients with SFTS,which can improve the patient's liver function and coagulation function and effectively inhibit the decline of blood CD4 + cells and excessive elevation of IL-6,it can reduce the risk of death in acute phase of SFTS.