目的探讨发热伴血小板减少综合征流行病学和病原学特点及临床和影像学特征,为该病的综合防治提供参考依据。方法 2012年1月至2017年1月枣庄市报告的发热伴血小板减少综合征患者149例,采用流行病学个案调查表对病例进行回归性分析,内容包括患者一般临床特征、实验室检查资料,肺与颅脑CT影像学资料分析等。采用Logistic回归分析筛查重症组患者发生的危险因素。结果 149例发热伴血小板减少患者中,未明确病因74例,人粒细胞无形体病感染2例,新布尼亚病毒感染73例。所有病例均为散发,无聚集倾向。轻症组布尼亚病毒感染47例,重症组布尼亚病毒感染26例。患者职业以农民为主,占84.56%(126/149)。发病前半月内有野外作业史占72.48%(108/149)。发病时间以每年的4-11月份多见,发病高峰在5、6、9和10月份。布尼亚病毒感染因素包括年龄(P<0.01),糖尿病(P<0.01),高血压病(P<0.05),冠心病(P<0.05),布尼亚病毒核酸(P<0.01)、血清降钙素原(P<0.01),CD4+CD25+T淋巴细胞比值(P<0.01)和血小板水平(P<0.05)。重症组患者肺部感染发生率100%,颅内多发低密度灶8例,病灶分布以多叶分布为主。经多因素非条件Logistic回归分析,发热伴血小板减少综合征患者新布尼亚病毒感染危险因素为:年龄(OR=1.654,P<0.01),糖尿病(OR=1.892,P<0.01),冠心病(OR=1.316,P<0.01),野外作业史(OR=2.464,P<0.01),蜱虫叮咬史(OR=2.905,P<0.01)。结论发热伴血小板减少综合征的发生呈季节性分布,年龄、糖尿病、冠心病、野外作业及蜱虫叮咬为新布尼亚病毒感染危险因素,可为该病的防治提供参考。 Objective To investigate the epidemiological and etiological characteristics of fever with thrombocytopenia syndrome and its clinical and radiological features and to provide a reference for the prevention and treatment of this disease. Methods A total of 149 patients with fever and thrombocytopenia syndrome reported from January 2012 to January 2017 in Zaozhuang City were retrospectively analyzed with the epidemiological case questionnaire. The data included the general clinical features, laboratory tests, Lung and brain CT imaging data analysis. Logistic regression analysis was used to screen the risk factors in critically ill patients. Results Among the 149 patients with fever and thrombocytopenia, 74 cases were not identified, 2 cases were AML infection, 73 cases were New Bunia virus infection. All cases were disseminated, no aggregation tendency. Forty-seven cases of Bunyanovirus infection in mild group and 26 cases of Bunyanovirus infection in severe group. Occupation of patients mainly farmers, accounting for 84.56% (126/149). There are 72.48% (108/149) of fieldwork history in the first half of the onset. The onset time is more common in April-November each year, the peak incidence in 5,6,9 and 10 months. Bunyavirus infection factors included age (P <0.01), diabetes (P <0.01), hypertension (P <0.05), coronary heart disease (P <0.05), Bunyavirus nucleic acid Procalcitonin (P <0.01), CD4 + CD25 + T lymphocyte ratio (P <0.01) and platelet level (P <0.05). Severe group of patients with pulmonary infection rate of 100%, intracranial multiple low-density lesions in 8 cases, the distribution of lesions mainly in leafy. According to multivariate non-conditional Logistic regression analysis, the risk factors of New Bunyan virus infection in patients with fever and thrombocytopenia were age (OR = 1.654, P <0.01), diabetes mellitus (OR = 1.892, (OR = 1.316, P <0.01), history of field work (OR = 2.464, P <0.01), history of tick bites (OR = 2.905, P <0.01). Conclusion The incidence of fever with thrombocytopenia syndrome is seasonal distribution. Age, diabetes, coronary heart disease, field work and tick bites are the risk factors for new Bunyan virus infection, which may provide reference for the prevention and treatment of this disease.