舟山海岛严重发热伴血小板减少综合征血常规及凝血功能分析

Analysis of hematological parameters and coagulation function in severe fever with thrombocytopenia syndrome in Zhoushan island

目的 探讨舟山海岛地区严重发热伴血小板减少综合征（severe fever with thrombocytopenia syndrome,SFTS）患者临床血常规及凝血功能特征.方法 采用血细胞分析仪及全自动凝血仪分别检测2011年5月至2013年10月舟山医院收治的27例SFTS患者治疗前及治疗10 d后血常规、凝血功能.x2检验、t检验或相关性分析血常规、凝血功能检测值的变化.结果 SFTS患者治疗前白细胞、中性粒细胞、淋巴细胞、血小板均明显低于正常体检者,差异有统计学意义（P＜0.05）;SFTS治疗痊愈者血小板明显高于死亡者,差异有统计学意义（P＜0.05）.SFTS患者治疗前PT、APTT、TT均较正常体检者长,FIB较正常体检者低,差异有统计学意义（P＜0.05）.Pearson相关性分析结果显示治疗前SFTS患者APTT与血小板数量有明显负相关性（P＜0.05）,治疗10 d后SFTS患者PT、APTT、TT与血小板数量亦有明显负相关性（P＜0.05）.结论 密切关注血常规及凝血功能状态对诊断及监测SFTS患者疾病进展情况具有非常显著的临床意义,并且特别需关注血小板及APTT的动态变化.

Objective To analyze the changes of hematological parameters and coagulatory function in sever fever with thrombocytopenia syndrome （SFTS） in Zhoushan island.Methods Automated blood analyzer and automatic coagulation analyzer were used to measure hematological parameters and coagulatory function in SFTS patients before and after ten days treatment.Results The counts of white blood cells （WBC）,neutrophils and lymphocytes and platelets of the 27 cases with SFTS were significantly lower than those of normal controls （P 〈 0.05） ; Moreover,the counts of platelets was significantly higher in the cases who recovered as compared with those who died （P 〈 0.05）.Prothrombin time （PT）,activated partial thromboplastin time （APTT） and thrombin time （TT） of SFTS patients before treatment were longer than normal controls,whereas fibrinogen （FIB） was lower （P 〈 0.05）.Pearson correlation analysis showed that APTT and platelet （PLT） of SFTS patients before treatment had significantly negative correlation （P 〈 0.05）,as well as PT,APTT and TT were negatively correlated with PLT of SFTS patients with 10 d treatment.Conclusion Paying close attention to the hematological parameters and coagulation function,especially PLT and APTT,has important clinical significance in diagnosis and monitoring of disease progression in patients with SFTS.