69例发热伴血小板减少综合征临床分析

Clinical Analysis of 69 Cases of Severe Fever with Thrombocytopenia Syndrome

探讨发热伴血小板减少综合征(SFTS)病例发生多器官功能损害的临床特点,分析影响其预后的相关指标。对69例SFTS患者进行回顾性分析,按病情程度划分为普通组与危重组,普通组病例35例,危重组34例。比较两组间肝、肾、心、脑等多器官功能障碍综合征(MODS)的发生及转归情况。69例SFTS患者均出现多器官功能损害,其中2个脏器受损9例,3个脏器受损8例,4个脏器受损28例,5个脏器受损8例,6个及以上脏器功能受损16例,死亡5例,总病死率7.25%。受损器官数量越多,病情越重,病死率越高。年龄≥60岁、男性、血小板计数(PLT)≤30×109/L、合并基础疾病以及高累计器官受损评分为危重症SFTS的高危因素。SFTS可导致多器官功能损害,对年龄≥60岁、男性、PLT≤30×109/L、合并基础疾病以及高累计器官受损评分的患者应高度重视,提示病情危重,预后差。

To investigate the clinical features of multiple organ dysfunction （MODS） in patients severe fever with thrombocytopenia syndrome （SFTS）, to analyze the parameters that may influence the prognosis of the disease. A retrospective analysis of 69 patients with SFTS was carried out. The cases were divided into mild and severe groups, to compare the incidence and prognosis of MODS such as liver, kidney, heart and brain in the two groups. All the 69 patients developed multiple organs dysfunction,and 9 cases with 2 organs dysfunction, 8 cases with 3 organs dysfunction, 28 cases with 4 organs dysfunction, 8 cases with 5 organs dysfunction, 16 cases with 6 organs dysfunction, 5 cases died. The total mortality rate was 7. 25%. The number of damaged organs is related to the severity and mortality of the disease. Old （greater or equal than 60 years）, male, platelet count（PLT） is less than or equal to 30 × 10^9/L, combined with basic disease and high cumulative organ damage score were risk factors of critically ill SFTS. SFTS can lead to multiple organ damage, age ≥60 years old, male, PLT≤30×10^9/L, combined with basic disease and high cumulative organ damage scores of patients should be highly valued and indicates the severity of illness and poor prognosis.