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| SFTS患者就医延迟与外周血线粒体损伤指数炎性因子指标的关联性分析及其对预后的影响 |
| Correlation between delay in medical consultation and peripheral blood mitochondrial damage index and inflammatory factor indexes in SFTS patients and its effect on prognosis |
| 投稿时间：2025-10-11 |
| DOI：10.3969/j.issn.1000-0399.2026.06.010 |
| 中文关键词: 发热伴血小板减少综合征 线粒体损伤 炎性因子 就医延迟 生存分析 预后 |
| 英文关键词: Severe fever with thrombocytopenia syndrome Mitochondrial damage Inflammatory markers Healthcare-seeking delay Survival analysis Prognosis |
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| 中文摘要: |
| 目的 探讨发热伴血小板减少综合征（SFTS）患者不同发病至入院时间与外周血线粒体损伤指数、炎性因子指标的关系，以及对其预后情况的分析。方法 回顾性分析2017年10月至2024年9月于安徽医科大学附属六安医院（六安市人民医院）就诊的220例SFTS患者资料，根据发病至入院时间分为T1组（≤3 d,n=60）、T2组（3～6 d,n=97）和T3组（≥7 d,n=63）。收集患者的一般资料，测定外周血线粒体损伤指数、炎性因子、凝血及血常规指标。通过Spearman相关性分析发病至入院时间与原发灶和外周血线粒体损伤指数、炎性因子指标的相关性；Kaplan-Meier生存曲线检验3组患者的28 d生存率差异，Cox回归分析检验发病至入院时间是否为死亡的独立风险因素。结果 入院48 h内，T3组的Th细胞线粒体损伤53例（84.13%）、Ts细胞线粒体损伤57例（90.48%）、hs-C反应蛋白（CRP）、白细胞介素-6（IL-6）、血小板压积（PCT）、白细胞（WBC）水平高于T1和T2组，血小板计数（PLT）水平低于T1和T2组（P<0.05）。Th细胞线粒体损伤、Ts细胞线粒体损伤与发病至入院时间呈正相关（rs=0.186、0.173;P<0.05）,hs-CRP、IL-6和PCT亦与发病至入院时间呈正相关（rs=0.185、0.344、0.270;P<0.05）。随访28 d,220例患者死亡35例，总病死率为15.91%，其中T1组死亡6例，T2组死亡14例，T3组死亡15例；Kaplan-Meier生存曲线分析发现，随着发病至入院时间延长，患者28 d生存率逐渐下降（Log-rank χ2=14.193,P<0.001）;Cox回归分析结果显示，发病至入院时间为SFTS患者死亡的独立危险因素（HR=1.118,P=0.002,95%CI:1.041～1.201）。结论 SFTS患者就医延迟与外周血线粒体损伤指数、炎性因子指标均呈正相关，且其为患者死亡的独立危险因素，发病至入院时间每延长1天，死亡风险增加11.8%。 |
| 英文摘要: |
| Objective TTo investigate the relationship between different onset-to-admission intervals and peripheral blood mitochondrial damage index as well as inflammatory markers in patients with severe fever with thrombocytopenia syndrome（SFTS）, and to analyze their prognostic implications. Methods A total of 220 patients diagnosed with SFTS at Lu'an Hospital Affiliated to Anhui Medical University（Lu'an People's Hospital） from October 2017 to September 2024 were enrolled. Based on the interval from symptom onset to hospital admission, patients were categorized into three groups: T1（≤3 days, n=60）, T2（3～6 days, n=97）, and T3（≥7 days, n=63）. Demographic and clinical data were collected. Peripheral blood mitochondrial damage index, inflammatory markers, coagulation parameters, and routine blood indices were measured. Spearman correlation analysis was employed to assess the associations between onset-to-admission interval and both mitochondrial damage index and inflammatory markers. Kaplan-Meier survival curves were constructed to compare 28-day survival rates among the three groups, with differences evaluated using the log-rank test. Cox regression analysis was performed to determine whether onset-toadmission interval independently predicted mortality. Results Within 48 hours of admission, the T3 group exhibited significantly higher proportions of Th cell mitochondrial damage（84.13%） and Ts cell mitochondrial damage（90.48%）, as well as elevated levels of hs-CRP, IL-6, PCT, and WBC, alongside lower PLT counts compared to the T1 and T2 groups（all P<0.05）. Both Th cell and Ts cell mitochondrial damage were positively correlated with onset-to-admission interval（rs=0.186, 0.173, respectively; both P<0.05）. Similarly, hs-CRP, IL-6, and PCT levels showed positive correlations with onset-to-admission interval（rs=0.185, 0.344, 0.270, respectively; all P<0.05）. During the 28-day follow-up period, 35 patients died, yielding an overall mortality rate of 15.91%, with 6 deaths in the T1 group, 14 in the T2 group, and 15 in the T3 group. Kaplan-Meier analysis revealed that prolonged onset-to-admission interval was associated with progressively lower 28-day survival rates（log-rank χ2=14.193, P<0.001）. Cox regression analysis identified onset-to-admission interval as an independent risk factor for mortality（β=0.112, P=0.002）, with a hazard ratio of 1.118（95% CI: 1.041～1.201）, indicating that each one-day delay in admission increased the risk of death by 11.8%. Conclusion Delayed healthcare-seeking in patients with SFTS is positively correlated with peripheral blood mitochondrial damage index and inflammatory markers. Furthermore, it independently predicts mortality, with each additional day from symptom onset to hospital admission conferring a 11.8% increase in mortality risk. |
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