目的对90例发热伴血小板减少综合征(severe fever with thrombocytopenia syndrome,SFTS)患者的实验室数据和临床特征进行分析,寻找重症患者预警指标,为临床干预提供依据。方法收集2020年3月至2021年9月安庆市立医院感染科收治的90例SFT...目的对90例发热伴血小板减少综合征(severe fever with thrombocytopenia syndrome,SFTS)患者的实验室数据和临床特征进行分析,寻找重症患者预警指标,为临床干预提供依据。方法收集2020年3月至2021年9月安庆市立医院感染科收治的90例SFTS患者,按病情轻重分为轻症组和重症组,其中轻症组44例,重症组46例,比较两组的流行病学特征、临床特征、实验室指标。结果90例患者均为散发病例,88例为农民,女性62例,男性28例,发病高峰主要集中在4-9月份。与轻症组比较,重症组中位年龄更高(分别为62岁和66岁,Z=-2.032,P=0.042);重症组热程更长(Z=-2.558,P=0.010)、皮肤瘀点瘀斑发生率更高(χ^(2)=9.406,P=0.002);重症组降钙素原、C反应蛋白、肌酐、尿素氮、谷草转氨酶、乳酸脱氢酶、肌酸激酶均高于轻症组(Z值分别为-2.041、-2.054、-3.576、-4.571、-4.452、-4.993、-4.500,均P<0.05),而血钙(t=-3.471)、血小板(Z=-8.124)、淋巴细胞计数(Z=-1.959)低于轻症组,差异均有统计学意义(均P<0.05);重症组并发中枢神经系统异常、肺炎、心肌损害、心动过缓、肝功能不全、横纹肌溶解的发生率均高于轻症组(χ^(2)分别为4.155、8.897、12.018、9.961、16.365、6.123,均P<0.05)。Logistic回归分析提示中枢神经系统异常(OR=20.314,95%CI:0.886~45.695)、血小板(OR=0.93,95%CI:0.888~0.973)、心肌损害(OR=4.813,95%CI:1.149~20.162)为重症预警独立危险因素。结论SFTS临床症状多样,出现血小板明显下降、中枢神经系统异常或是心肌酶谱异常,应警惕可能进展为重症SFTS。展开更多
Rationale: Malaria and dengue are the most prevalent vector-borne diseases in tropical countries. Plasmodium parasite and dengue virus(DENV) concurrent infection is possible and often under-recognized in geographical ...Rationale: Malaria and dengue are the most prevalent vector-borne diseases in tropical countries. Plasmodium parasite and dengue virus(DENV) concurrent infection is possible and often under-recognized in geographical areas where these infections are both endemic.Patients concern and diagnosis: We describe the first two cases of Plasmodium falciparum and DENV-3 co-infection in travelers returning to northeastern Italy from Burkina Faso during 2013-2014.Interventions: Malaria infection in both patients was treated with mefloquine. Due to the persistence of symptoms despite of the antimalaria treatment, dengue was also investigated;the treatment of dengue was symptomatic.Outcomes: The patients were discharged in good general condition.Lessons: The need for surveillance of potential malaria and dengue co-infection in travelers returning to Europe from endemic areas is highlighted, as infection with Plasmodium does not exclude arboviral co-infection.展开更多
文摘目的对90例发热伴血小板减少综合征(severe fever with thrombocytopenia syndrome,SFTS)患者的实验室数据和临床特征进行分析,寻找重症患者预警指标,为临床干预提供依据。方法收集2020年3月至2021年9月安庆市立医院感染科收治的90例SFTS患者,按病情轻重分为轻症组和重症组,其中轻症组44例,重症组46例,比较两组的流行病学特征、临床特征、实验室指标。结果90例患者均为散发病例,88例为农民,女性62例,男性28例,发病高峰主要集中在4-9月份。与轻症组比较,重症组中位年龄更高(分别为62岁和66岁,Z=-2.032,P=0.042);重症组热程更长(Z=-2.558,P=0.010)、皮肤瘀点瘀斑发生率更高(χ^(2)=9.406,P=0.002);重症组降钙素原、C反应蛋白、肌酐、尿素氮、谷草转氨酶、乳酸脱氢酶、肌酸激酶均高于轻症组(Z值分别为-2.041、-2.054、-3.576、-4.571、-4.452、-4.993、-4.500,均P<0.05),而血钙(t=-3.471)、血小板(Z=-8.124)、淋巴细胞计数(Z=-1.959)低于轻症组,差异均有统计学意义(均P<0.05);重症组并发中枢神经系统异常、肺炎、心肌损害、心动过缓、肝功能不全、横纹肌溶解的发生率均高于轻症组(χ^(2)分别为4.155、8.897、12.018、9.961、16.365、6.123,均P<0.05)。Logistic回归分析提示中枢神经系统异常(OR=20.314,95%CI:0.886~45.695)、血小板(OR=0.93,95%CI:0.888~0.973)、心肌损害(OR=4.813,95%CI:1.149~20.162)为重症预警独立危险因素。结论SFTS临床症状多样,出现血小板明显下降、中枢神经系统异常或是心肌酶谱异常,应警惕可能进展为重症SFTS。
文摘Rationale: Malaria and dengue are the most prevalent vector-borne diseases in tropical countries. Plasmodium parasite and dengue virus(DENV) concurrent infection is possible and often under-recognized in geographical areas where these infections are both endemic.Patients concern and diagnosis: We describe the first two cases of Plasmodium falciparum and DENV-3 co-infection in travelers returning to northeastern Italy from Burkina Faso during 2013-2014.Interventions: Malaria infection in both patients was treated with mefloquine. Due to the persistence of symptoms despite of the antimalaria treatment, dengue was also investigated;the treatment of dengue was symptomatic.Outcomes: The patients were discharged in good general condition.Lessons: The need for surveillance of potential malaria and dengue co-infection in travelers returning to Europe from endemic areas is highlighted, as infection with Plasmodium does not exclude arboviral co-infection.
