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向旭.发热伴血小板减少综合征患者肝功能指标对预后有预测价值[J].内科急危重症杂志,2026,32(3):229-232
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| DOI：10.11768/nkjwzzzz20260304 |
| 中文关键词: 新型布尼亚病毒 发热伴血小板减少综合征 天门冬氨酸转氨酶 乳酸脱氢酶 预后 危险因素 |
| 英文关键词:Novel bunyavirus Severe fever with thrombocytopenia syndrome Aspartate transaminase Lactate dehydrogenase Prognosis Risk factors |
| 基金项目:2026年省自然科学基金创新发展联合基金项目（2026AFC1222） |
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| 中文摘要: |
| 摘要 目的：探讨新型布尼亚病毒感染致发热伴血小板减少综合征(SFTS)患者入院时肝功能情况，分析预后相关影响因素。方法：回顾性选取120例SFTS患者的病历资料，根据入院28 d预后情况，分为存活组69例和死亡组51例。比较分析2组SFTS患者入院24 h内首次检查的肝功能指标丙氨酸转氨酶（ALT）、天门冬氨酸转氨酶（AST）、总蛋白（TP）、白蛋白（ALB）、总胆红素（TB）、直接胆红素（DB）、碱性磷酸酶（ALP）、γ-谷氨酰转肽酶（GGT）、乳酸脱氢酶（LDH）水平，绘制受试者工作特征（ROC）曲线，计算灵敏度、特异性和曲线下面积（AUC）。采用多因素Logistic回归方程分析影响患者预后的独立危险因素,建立风险预警模型。结果：2组患者性别、血TB比较，差异无统计学意义（P均>0.05）；与存活组比较，死亡组血TP、ALB显著降低,ALT、AST、DB、ALP、GGT、LDH显著升高（P均<0.05）。多因素Logistic回归分析显示，入院时年龄、血AST、LDH是 SFTS预后的独立危险因素（P均<0.05），ROC曲线显示，以上3项指标构建的列线图模型对SFTS患者预后的预测效能良好(AUC=0.823,95%CI：0.747~0.900,P<0.001)。结论：SFTS患者肝功能异常发生率较高，年龄、血AST、LDH水平有助于判断SFTS预后。 |
| 英文摘要: |
| Abstract Objective: To investigate the liver function of patients with severe fever with thrombocytopenia syndrome (SFTS) caused by novel bunyavirus infection at admission, and analyze the influencing factors related to prognosis. Methods: A total of 120 patients with SFTS were retrospectively enrolled. According to the 28-day prognosis after admission, the patients were divided into a survival group (69 cases) and a death group (51 cases). Liver function indicators were compared between the two groups, including alanine transaminase (ALT), aspartate transaminase (AST), total protein (TP), albumin (ALB), total bilirubin (TB), direct bilirubin (DB), alkaline phosphatase (ALP), γ-glutamyl transpeptidase (GGT), and lactate dehydrogenase (LDH). All data were from the first examination within 24 h of admission. Receiver operating characteristic (ROC) curves were plotted to calculate the sensitivity, specificity and area under the curve (AUC). Multivariate Logistic regression analysis was used to identify independent risk factors affecting prognosis, and a risk early warning model was established. Results: There were no significant differences in gender and TB level between the two groups (all P> 0.05). The death group had significantly lower TP and ALB levels, and significantly higher ALT, AST, DB, ALP, GGT and LDH levels than the survival group (all P< 0.05). Multivariate Logistic regression analysis showed that age, AST and LDH levels were independent risk factors for the prognosis of SFTS (all P< 0.05). ROC curve analysis indicated that the nomogram model constructed based on these three indicators had good predictive performance for the prognosis of SFTS patients (AUC= 0.823, 95%CI: 0.747-0.900, P< 0.001). Conclusion: Abnormal liver function is common in patients with SFTS. Age, AST and LDH levels are helpful for predicting the prognosis of SFTS. |
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