信阳市992例发热伴血小板减少综合征病例分析

Analysis of 992 cases of severe fever with thrombocytopenia syndrome in Xinyang City

目的探讨发热伴血小板减少综合征的流行病学及临床特征,提高对该病的认识和治愈率。方法对2018—2020年信阳市992例SFTS患者的流行病学资料及临床资料进行回顾性分析。结果992例SFTS患者中,重症比例占23.19%,平均病死率为14.95%,2018—2020年SFTS病死率差异有统计学意义(χ^(2)=49.852,P<0.001)。其中男性395例,女性597例,男女比例1:1.51;60~69岁年龄段发病人数最多,占35.08%;职业以农民为主,占93.85%;地处山区、丘陵地区的商城、光山县的SFTS病例构成比例约占总发病数的51.31%;发病前有野外活动史或田间劳动史占96.16%,有明确蜱叮咬史占25.91%,5月份发病比例占24.29%。临床上以发热、乏力、纳差、恶心、全身酸痛和腹股沟淋巴结肿大、触痛为主;血常规发现白细胞计数减少和血小板降低;蛋白尿、血尿、凝血时间延长和生化指标改变为主。结论发热伴血小板减少综合征是一种高致死性的病毒性传染病,患者有明显的流行病史,临床特点典型。

Objective To investigate the epidemiological and clinical characteristics of severe fever with thrombocytopenia syndrome(SFTS),and to improve the understanding and cure rate of SFTS.Method The epidemiological and clinical data of 992 SFTS patients in Xinyang City from 2018 to 2020 were retrospectively analyzed.Results Among 992 cases of SFTS,23.19%were severe cases,and the average fatality rate was 14.95%.There was significant difference in the fatality rate of SFTS from 2018 to 2020(χ^(2)=49.852,P<0.001).There were 395 males and 597 females,with a male/female ratio of 1:1.51.The number of patients aged 60-69 was the largest,accounting for 35.08%,and farmers were the main occupation,accounting for 93.85%.The proportion of SFTS cases in Shangcheng and Guangshan County in mountainous and hilly areas accounted for 51.31%of the total cases.96.16%had a history of outdoor activities or field work before onset,25.91%had a clear tick bite history,and 24.29%had onset in May.Clinical symptoms include fever,fatigue,poor appetite,nausea,systemic soreness and inguinal lymph node enlargement and tenderness.Blood routine showed decreased white blood cell count and thrombocytopenia.Proteinuria,hematuria,prolongation of coagulation time and change of biochemical indexes were the main factors.Conclusion SFTS is a highly fatal viral infectious disease.The patients have obvious epidemic history and typical clinical features.