发热伴血小板减少综合征患者病死率及临床特征的Meta分析

Fatality rate and clinical characteristics of SFTS patients:a meta-analysis

目的对文献报道的发热伴血小板减少综合征(SFTS)患者的病死率和临床特征进行Meta分析。方法计算机检索PubMed、Embase、The Cochrane Library、CMB、CNKI和VIP数据库。选择报告SFTS临床特征的无对照观察性研究,摘录有关的信息,使用STATA 11软件对所选定的数据进行合并。结果中国地区21篇文献共4320例,韩国地区3篇文献共262例实验室确诊为SFTS的患者被纳入Meta分析。中国地区SFTS患者合并病死率为16.6%(95%CI:0.155,0.177);韩国地区SFTS患者合并病死率为28.8%(95%CI:0.104,0.471)。中国地区SFTS患者各临床表现的合并阳性率为发热81%(95%CI:0.680,0.941)、乏力81.3%(95%CI:0.754,0.872)、血小板减少82.9%(95%CI:0.713,0.945)、白细胞减少84.9%(95%CI:0.808,0.891)、恶心54.2%(95%CI:0.467,0.617)、厌食77.2%(95%CI:0.690,0.854)及出血性表现13.8%(95 CI:0.103,0.172);韩国地区SFTS患者各临床表现的合并阳性率为发热87.7%(95%CI:0.810,0.945)、乏力55.2%(95%CI:0.180,0.923)、血小板减少88.5%(95%CI:0.819,0.950)、白细胞减少90.1%(95%CI:0.840,0.963)、腹泻50.9%(95%CI:0.285,0.733)及出血性表现23.4%(95%CI:0.041,0.426)。结论发热、乏力、血小板减少及白细胞减少为所有SFTS患者的共同临床表现,中国地区SFTS患者的胃肠道症状以恶心及厌食为主要表现,而韩国地区主要以腹泻为主。

Objective To systematically review the polled case fatality rate and clinical characteristics of SFTS patients reported in the literature.Methods We searched PubMed,Embase,Cochrane Library,CMB,CNKI,and VIP databases.Uncontrolled observational studies that reported the clinical characteristics of SFTS was selected,relevant information was extracted,and selected data were analyzed using STATA 11 software.Results A total of 21 articles involving 4320 patients in China and 3 articles involving 262 patients in Korea met the inclusion criteria.The polled case fatality rate of SFTS patients in China was 16.6%(95%CI:0.155,0.177),and the polled case fatality rate of SFTS patients in South Korea was 28.8%(95%CI:0.104,0.471).The polled positive rates of clinical manifestations in SFTS patients in China:fever 81%(95%CI:0.680,0.941),fatigue 81.3%(95%CI:0.754,0.872),and thrombocytopenia 82.9%(95%CI:0.713,0.945)),leucopenia 84.9%(95%CI:0.808,0.891),nausea 54.2%(95%CI:0.467,0.617),anorexia 77.2%(95%CI:0.690,0.854)and hemorrhagic manifestation 13.8%(95%CI:0.103,0.172);the polled positive rate of clinical manifestations in SFTS patients in South Korea:fever 87.7%(95%CI:0.810,0.945),fatigue 55.2%(95%CI:0.180,0.923),thrombocytopenia 88.5%(95%CI:0.819,0.950),leukopenia 90.1%(95%CI:0.840,0.963),diarrhea 50.9%(95%CI:0.285,0.733)and hemorrhagic manifestation 23.4%(95%CI:0.041,0.426).Conclusions The clinical manifestations of all SFTS patients are mainly fever with fatigue,thrombocytopenia and leukopenia.The gastrointestinal symptoms of SFTS patients in China are mainly nausea and anorexia.While diarrhea is the major manifestation of gastrointestinal symptoms in SFTS patients in Korea.