本文關(guān)鍵詞： 發(fā)熱伴血小板減少綜合征 布尼亞病毒感染 危險(xiǎn)因素 流行病學(xué)　出處：《中國(guó)病原生物學(xué)雜志》2017年09期 　論文類型：期刊論文

【摘要】：目的探討發(fā)熱伴血小板減少綜合征流行病學(xué)和病原學(xué)特點(diǎn)及臨床和影像學(xué)特征,為該病的綜合防治提供參考依據(jù)。方法 2012年1月至2017年1月棗莊市報(bào)告的發(fā)熱伴血小板減少綜合征患者149例,采用流行病學(xué)個(gè)案調(diào)查表對(duì)病例進(jìn)行回歸性分析,內(nèi)容包括患者一般臨床特征、實(shí)驗(yàn)室檢查資料,肺與顱腦CT影像學(xué)資料分析等。采用Logistic回歸分析篩查重癥組患者發(fā)生的危險(xiǎn)因素。結(jié)果 149例發(fā)熱伴血小板減少患者中,未明確病因74例,人粒細(xì)胞無(wú)形體病感染2例,新布尼亞病毒感染73例。所有病例均為散發(fā),無(wú)聚集傾向。輕癥組布尼亞病毒感染47例,重癥組布尼亞病毒感染26例�；颊呗殬I(yè)以農(nóng)民為主,占84.56%(126/149)。發(fā)病前半月內(nèi)有野外作業(yè)史占72.48%(108/149)。發(fā)病時(shí)間以每年的4-11月份多見,發(fā)病高峰在5、6、9和10月份。布尼亞病毒感染因素包括年齡(P0.01),糖尿病(P0.01),高血壓病(P0.05),冠心病(P0.05),布尼亞病毒核酸(P0.01)、血清降鈣素原(P0.01),CD4+CD25+T淋巴細(xì)胞比值(P0.01)和血小板水平(P0.05)。重癥組患者肺部感染發(fā)生率100%,顱內(nèi)多發(fā)低密度灶8例,病灶分布以多葉分布為主。經(jīng)多因素非條件Logistic回歸分析,發(fā)熱伴血小板減少綜合征患者新布尼亞病毒感染危險(xiǎn)因素為:年齡(OR=1.654,P0.01),糖尿病(OR=1.892,P0.01),冠心病(OR=1.316,P0.01),野外作業(yè)史(OR=2.464,P0.01),蜱蟲叮咬史(OR=2.905,P0.01)。結(jié)論發(fā)熱伴血小板減少綜合征的發(fā)生呈季節(jié)性分布,年齡、糖尿病、冠心病、野外作業(yè)及蜱蟲叮咬為新布尼亞病毒感染危險(xiǎn)因素,可為該病的防治提供參考。
[Abstract]:Objective to investigate the epidemiological and etiological characteristics and clinical and imaging features of fever with thrombocytopenia syndrome. Methods from January 2012 to January 2017, 149 cases of fever with thrombocytopenia syndrome were reported in Zaozhuang city. The epidemiological case questionnaire was used to carry on the regression analysis to the case, including the general clinical characteristic of the patient, the laboratory examination data. Logistic regression analysis was used to screen the risk factors in severe patients. Results in 149 patients with fever and thrombocytopenia. There were 74 cases of unknown etiology, 2 cases of human granulocytic disease and 73 cases of new Bunia virus infection. All the cases were sporadic and had no tendency to gather. In mild group, 47 cases were infected with Bunia virus. There were 26 cases of Bunia virus infection in the severe group. The occupation of the patients was mainly farmers. Accounting for 84.56 / 126 / 149. In the first half month before the onset of the disease, there was a history of field work, accounting for 72.48 / 108 / 149. The onset time was more frequent in April-November of each year, and the peak incidence was at 5. 6 / 9 and October. The infection factors of Bunia virus included age, diabetes mellitus, hypertension and coronary heart disease. Bunia virus nucleic acid (P0.01) and serum procalcitonin (P0.01). CD4 CD25 T lymphocyte ratio (P0.01) and platelet level P0.050.The incidence of pulmonary infection was 100 in the severe group and 8 patients had multiple intracranial low-density foci. The distribution of lesions was mainly multilobular and multivariate conditional Logistic regression analysis was used. The risk factors of neobonia virus infection in patients with fever and thrombocytopenia syndrome were: the age of ORV was 1.654% (P0.01), and that of diabetes mellitus was 1.892g / P0.01). Coronary heart disease (CHD) was 1.316m (P0.01A), field work was (2.464) (P0.01A) and ticks bite was (2.905). Conclusion the incidence of fever with thrombocytopenia syndrome is seasonal, age, diabetes, coronary heart disease, field work and ticks bite are risk factors of neobonia virus infection. It can provide reference for the prevention and cure of the disease.
【作者單位】： 棗莊市薛城區(qū)人民醫(yī)院;
【分類號(hào)】：R181.3;R510
【正文快照】： 發(fā)熱伴血小板減少綜合征是臨床出現(xiàn)發(fā)熱癥狀同時(shí)伴有血小板減少為主要特征的一系列臨床綜合征。多數(shù)患者伴血清肌酶升高或輕度消化系統(tǒng)癥狀。嚴(yán)重者可伴多臟器功能損傷,以凝血機(jī)制異常、肝酶升高為主,部分患者病情可進(jìn)展迅速,伴心力衰竭以及神志改變,出現(xiàn)多臟器功能衰竭,臨床

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