轻症和重症发热伴血小板减少综合征的血常规和凝血功能差异研究

摘要

Objective To investigate the clinical value of blood routine tests ( RT) and coagulation function in differential diagnosis of mild and severe patients infected with bunyamwera virus. Methods Twenty-five mild patients and 25 severe patients infected with bunyamwera virus were selected and their blood RT and coagulation function tests were performed. Results The earliest prothrombin time ( PT-early) and activated partial thromboplastin time( APTT-early) were significantly lower than those of severe patients (t=-2. 43, P<0. 05; t=-2. 53, P<0. 05). The lowest values of white blood cells (WBC-low) of mild patients were significantly higher than those of severe patients ( t=5. 66, P<0. 01) . The highest value of D-dimer ( DD-high) of mild patients were significantly lower than that of severe patients ( z=1. 35, P<0. 05) . When mild patients values were set as outcome variable, AUC of APTT-early was the highest ( AUC=0. 713, P<0. 05) . When values of severe patients were set as outcome variable, AUC of DD-high was the highest ( AUC=0. 874, P<0. 01). Conclusions APTT-early and DD-high are suitable for differential diagnosis of mild and severe patients infected with bunyamwera virus.%目的 探讨轻症和重症新型布尼亚病毒感染致发热伴血小板减少综合征(severe fever with thrombocytopenia syndrome,SFTS)患者的血常规和凝血功能差异,为临床诊治提供依据.方法 选择本院2015年3月至2018年12月期间收治的轻、重症SFTS患者各25例,检测患者入院后血常规和凝血功能指标结果 .结果 轻症SFTS患者组入院最早一次凝血酶原时间结果 (PT-early)和部分活化凝血酶原时间结果 (APTT-early)低于重症SFTS患者组,差异具有统计学意义(t=-2.43,P<0.05;t=-2.53,P<0.05).轻症SFTS患者组入院白细胞最低一次结果 (WBC-low)高于重症SFTS患者组,差异具有统计学意义(t=5.66,P<0.01).轻症SFTS患者组入院D二聚体最高一次结果 (DD-high)低于重症SFTS患者组,差异具有统计学意义(z=1.35,P<0.05).当结局变量选择轻症SFTS患者,指标中以APTT-early的正向预测能力最强(AUC=0.713,P<0.05).当结局变量选择重症SFTS患者,指标中以WBC-low的反向预测能力最强(AUC=0.874,P<0.01).结论 APTT-early和WBC-low可作为轻、重症SFTS患者转化预测的依据.