发热伴血小板减少综合征患者脏器损伤特征研究
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1无锡市第二人民医院(江南大学附属中心医院)急诊医学科,江苏 无锡 214002 ; 2.南京医科大学第一附属医院急诊医学科 ; 3.心血管内科,江苏 南京 210029

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R558.2

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国家自然科学基金(82000335)


Characteristics of organ injury in patients with severe fever with thrombocytopenia syndrome
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1Department of Emergency Medicine,Wuxi No.2 People’s Hospital(Jiangnan University Medical Center),Wuxi 214002 ; 2.Department of Emergency Medicine ; 3.Department of Cardiology,the First Affiliated Hospital of NanjingMedical University,Nanjing 210029 ,China

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    摘要:

    目的:对发热伴血小板减少综合征(severe fever with thrombocytopenia syndrome,SFTS)患者脏器损伤特征进行总结。方法:回顾性收集2023年1月—2024年12月于南京医科大学第一附属医院就诊并收住入院的SFTS患者,统计住院期间并发脏器损伤情况,通过Logistic回归分析探讨脏器损伤与预后相关性,最终构建基于SFTS患者脏器损伤评估的出院转归预测列线图。结果:共纳入284例SFTS患者,共有252(88.7%)例SFTS患者合并脏器损伤,其中,心脏是最常累及的脏器。多因素 logistic 回归分析结果显示,年龄(OR=1.103,95%CI:1.042~1.176,P=0.001)、胰腺损伤(OR=3.414,95%CI:1.296~9.299,P= 0.014)、肾损伤(OR=16.365,95%CI:5.699~53.234,P < 0.001)、肺损伤(OR=3.805,95%CI:1.494~9.955,P=0.005)和脑损伤(OR= 3.414,95%CI:1.283~9.289,P=0.014)可独立增加SFTS患者死亡风险。构建基于SFTS患者脏器损伤评估的出院转归预测列线图可准确预测患者出院转归,Bootstrap 抽样 1 000 次行内部验证显示平均受试者工作特征(receiver operating characteristic, ROC)曲线下面积为0.937(95%CI:0.910~0.965)。结论:SFTS患者大多合并脏器损伤,年龄增加和胰腺、肾、肺、脑损伤增加 SFTS患者死亡风险。基于脏器损伤的出院转归预测列线图具有良好的临床应用价值。

    Abstract:

    Objective:To summarize the characteristics and patterns of organ injury in patients diagnosed with severe fever with thrombocytopenia syndrome(SFTS). Methods:A retrospective analysis was conducted on patients with SFTS admitted to the First Affiliated Hospital of Nanjing Medical University between January 2023 and December 2024. During hospitalization,concurrent organ injuries were recorded and statistically analyzed. Logistic regression analysis was performed to evaluate the association between organ injury and prognosis. Furthermore,a nomogram was developed to predict discharge outcomes based on organ injury assessment in SFTS patients. Results:A total of 284 SFTS patients were enrolled in this study,among whom 252(88.7%)exhibited signs of organ injury. Cardiac injury was most commonly observed. Multivariate logistic regression analysis revealed that age(OR=1.103,95%CI:1.042-1.176, P=0.001),pancreatic injury(OR=3.414,95%CI:1.296-9.299,P=0.014),renal injury(OR=16.365,95%CI:5.699-53.234,P < 0.001), pulmonary injury(OR=3.805,95%CI:1.494-9.955,P=0.005),and cerebral injury(OR=3.414,95%CI:1.283-9.289,P=0.014)were independently associated with increased risk of in-hospital mortality in SFTS patients. The constructed nomogram demonstrated strong predictive performance for discharge outcomes. Internal validation using the bootstrap method(resampling=1 000)showed an average area under the receiver operating characteristic(ROC)curve of 0.937(95% CI:0.910- 0.965). Conclusion:The majority of SFTS patients experienced concurrent organ injuries. Increased age these,pancreatic,renal,pulmonary,and cerebral injuries were significantly associated with increased mortality risk. The nomogram based on organ injuries for predicting discharge outcomes had good clinical application value.

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张晓敏,张忠满,朱轶,武澎.发热伴血小板减少综合征患者脏器损伤特征研究[J].南京医科大学学报(自然科学版),2025,45(12):1799-1804

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  • 收稿日期:2025-08-13
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  • 在线发布日期: 2025-12-13
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