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目的通过对发热伴血小板减少综合征患者临床特征分析,提高对该病的认识。方法对丹东市宽甸县医院2010年6月至2015年12月实验室确诊的98例发热伴血小板减少综合征患者的临床表现、实验室检查结果及预后进行回顾性分析总结,多因素分析SFTS患者死亡相关危险因素。结果所有患者均生活居住在丘陵地带,80例(81.6%)患者在夏秋季发病。在患者工作和居住环境经常能发现蜱虫。患者临床表现为发热,肌痛,腹泻,白细胞及血小板减少,部分患者可以出现肺炎,脑炎,DIC,继发感染等。死亡率为14.3%,当乳酸脱氢酶大于正常值上限两倍以上,APTT最高值≥70秒和存在神经系统症状的患者为死亡独立预测因素。结论乳酸脱氢酶大于正常值上限两倍以上,APTT最高值≥70秒和存在神经系统症状的患者为死危险因素,临床医生对这部分患者要严格重视。
Objective To analyze the clinical features of patients with fever and thrombocytopenia to improve their understanding of the disease. Methods The clinical manifestations, laboratory findings and prognosis of 98 patients diagnosed as fever with thrombocytopenia in Kuandian County Hospital of Dandong City from June 2010 to December 2015 were retrospectively analyzed and summarized. Multivariate analysis of SFTS Patient mortality related risk factors. Results All patients lived in hilly areas and 80 (81.6%) patients developed disease in summer and autumn. Tickets are often found in patients’ working and living environments. Patients with clinical manifestations of fever, myalgia, diarrhea, leukopenia and thrombocytopenia, some patients may be pneumonia, encephalitis, DIC, secondary infection. Mortality was 14.3%, with independent predictors of death when lactate dehydrogenase was more than twice the upper limit of normal, patients with APTT values ≥70 seconds and those with neurological symptoms. Conclusion Lactate dehydrogenase more than twice the upper limit of normal, APTT highest value ≥ 70 seconds and the presence of neurological symptoms in patients with risk factors for death, clinicians should pay close attention to this part of the patients.