Clinical Characteristics And Risk Factors Of Severe Fever With Thrombocytopenia Syndrome

Research BackgroundSevere fever with thrombocytopenia syndrome(SFTS)is an infectious disease.It is a new type of hemorrhagic fever caused by the new Bunia virus(CSFTSV).Its clinical manifestations are fever,thrombocytopenia,gastrointestinal discomfort and multiple organ injury.The first case of this disease was reported by China in 2009.Subsequently,it was found and reported in Japan,Korea and other countries.It was reported that the early stage of the disease had a high mortality rate,once as high as 50%.In recent years,the number of patients with this disease has been increasing year by year,which has been reported in23 provinces in China.The Ministry of Health also attached great importance to the disease.In 2010,fever with thrombocytopenia syndrome was included in the disease surveillance system.It was stipulated that the surveillance data should be recorded and reported by the local CDC.The information reported from different places provides valuable demographic information,and more and more institutions have studied the disease in recent years.However,due to the complex pathogenesis and diverse symptoms of the disease,the current research results can not provide more practical local detailed information on clinical symptoms and risk factors.Therefore,this study was conducted in XXX Hospital from March 2016 to September 2018.100 patients with fever and thrombocytopenia syndrome were studied retrospectively,including epidemiology,clinical characteristics,laboratory results and risk factors,in order to provide reference for clinical prevention and treatment.Research objectiveTo explore the epidemiological and clinical characteristics of fever with thrombocytopenia syndrome,and to analyze the risk factors of fever with thrombocytopenia syndrome,so as to provide a theoretical basis for the prevention and clinical diagnosis of the disease.Research methodsIn this study,100 patients with fever and thrombocytopenia syndrome were treated in XX Hospital from March 2016 to September 2018.The epidemiological and clinical characteristics of the patients were retrospectively studied,the risk factors of the disease were analyzed,and the data collected were analyzed by SPSS22.0 statistical software.Research results1.Epidemiological characteristicsFemale patients(58,58%)were more than male patients(42,42%).Patients over 60 years old(36%)were significantly more than those in other age groups(17-45,24%),(46-60,28%),(< 16,12%).Field work(66 cases)had more patients than field play(23 cases)and accompanying patients(11 cases).In terms of epidemic time,no one was ill in January-March and December,9 cases(9%)in April,23 cases(23%)in May,17 cases(17%)in June,19 cases(19%)in July,15cases(15%)in August,5 cases(5%)in September,11 cases(11%)in October and 1 case(1%)in November.Twenty-three percent of the patients had a history of tick bites within two weeks.2.Clinical characteristicsAll the 100 patients had fever(100%),nausea and vomiting(72%),nausea and vomiting(62%),muscle ache(44%),abdominal pain and diarrhea(18%),hematemesis and melena(17%),lymphadenopathy(31%),cough and sputum(32%),chest tightness and asthma(11%),headache(26%),epilepsy(15%)and mental change(14%).Laboratory tests showed that WBC,neutrophil percentage(N%)and platelet count(PLT)were all decreased(100%)in all patients.Later,with the progression of disease and the occurrence of infection,they could be normal or increased.The plasma thrombin time(TT),activated partial thromboplastin time(APTT)and lactate dehydrogenase(LDH)were increased in all patients(100.00%).Alpha-pyruvic transaminase(ALT)(94%),direct bilirubin(DB)(49%),creatinine(SCr)(22%),urea nitrogen(BUN)(22%),amylase(30.00%),troponin(TNT)(16%),cerebrospinal fluid cell count(26%),creatine kinase(CK)(32%),occult blood(100.00%)and urine protein(88%)increased.3.Risk factors22 patients died.In clinical manifestations,respiratory failure(82%),oliguria(50%),hematemesis and melena(45%),epilepsy(50%)and mental change(82%)were most common in the death group.The symptoms were more obvious than those in survival group(6%,3%,6%,4%,1%)and the difference was significant(P < 0.05).In the laboratory examination,ALT,AST,SCr,APTT and TT in the dead group were all decreased,and the difference was significant(P < 0.05).Research conclusions1.Epidemiological characteristicsFemale SFTS patients were more than male;most of them were middle-aged and elderly people;the main groups were field workers and field tourists;the epidemic time was mainly from May to October;some patients had a history of tick bites within two weeks before onset of SFTS.2.Clinical characteristicsAll patients had fever symptoms,most of them had digestive system symptoms such as anorexia,nervous system symptoms such as epilepsy and mental changes,liver,kidney,pancreas and other organs and systems had different degrees of damage.White blood cell count(WBC),neutrophil percentage(N%)and platelet count(PLT)decreased in all patients,while plasma thrombin time(TT),activated partial thromboplastin time(APTT),lactate dehydrogenase(LDH),alanine aminotransferase(ALT),direct bilirubin(DB),creatinine(SCr),urea nitrogen(BUN),amylase,troponin(TNT),creatine kinase(CK)and urine protein increased.High.3.Risk factorsDeath of SFTS patients and clinical symptoms such as senility,respiratory failure,hematemesis and blackstool,epilepsy,mental changes,coagulation dysfunction,alanine aminotransferase(ALT),aspartate aminotransferase(AST),creatinine(SCr),activated partial coagulation...