PDF(Pubmed)
Abstract：
BACKGROUND: Optimal treatment strategy for severe fever with thrombocytopenia syndrome (SFTS) remained unknown. We aimed to evaluate the efficacy of intravenous immunoglobulin (IVIG) on SFTS.
METHODS: A retrospective cohort study was conducted based on medical records of the laboratory-confirmed SFTS patients hospitalized during 2010-2020 in the 154th hospital, China. A 1:1 propensity score matching with age, sex, the interval from symptom onset to admission, presence of chronic viral hepatitis, diabetes and disease severity was performed between Non-IVIG group (supportive therapy) and IVIG group (IVIG plus supportive therapy). The matching variables were adjusted to compare the case fatality rates (CFRs), viral load and laboratory parameters between the two groups. Risk ratio (RR) and 95% confidence interval (CI) were reported.
RESULTS: Totally 2219 SFTS patients were recruited. CFRs were significantly higher in 1051 patients in IVIG group than 1168 patients in Non-IVIG group (19.0% vs. 4.6%, RR = 4.30, 95% CI 3.12-5.93). The difference remained significant after matching (17.2% vs. 5.1%, RR = 4.02, 95% CI 2.71-5.97). The CFR of IVIG group was significantly higher in all age groups, two IVIG therapy delay groups and two therapy duration groups compared to that of Non-IVIG group (all P < 0.05). IVIG therapy was related to higher viral loads and reduced counts of lymphocytes, T cells, CD4+ T cells and natural killer cells in the blood (all P < 0.05).
CONCLUSIONS: No obvious efficacy of IVIG in saving life or improving outcome of SFTS was observed. Caution is needed for clinical physicians to continue prescribing IVIG for SFTS patients.
BACKGROUND: Natural Science Foundation of China.
METHODS: A retrospective cohort study was conducted based on medical records of the laboratory-confirmed SFTS patients hospitalized during 2010-2020 in the 154th hospital, China. A 1:1 propensity score matching with age, sex, the interval from symptom onset to admission, presence of chronic viral hepatitis, diabetes and disease severity was performed between Non-IVIG group (supportive therapy) and IVIG group (IVIG plus supportive therapy). The matching variables were adjusted to compare the case fatality rates (CFRs), viral load and laboratory parameters between the two groups. Risk ratio (RR) and 95% confidence interval (CI) were reported.
RESULTS: Totally 2219 SFTS patients were recruited. CFRs were significantly higher in 1051 patients in IVIG group than 1168 patients in Non-IVIG group (19.0% vs. 4.6%, RR = 4.30, 95% CI 3.12-5.93). The difference remained significant after matching (17.2% vs. 5.1%, RR = 4.02, 95% CI 2.71-5.97). The CFR of IVIG group was significantly higher in all age groups, two IVIG therapy delay groups and two therapy duration groups compared to that of Non-IVIG group (all P < 0.05). IVIG therapy was related to higher viral loads and reduced counts of lymphocytes, T cells, CD4+ T cells and natural killer cells in the blood (all P < 0.05).
CONCLUSIONS: No obvious efficacy of IVIG in saving life or improving outcome of SFTS was observed. Caution is needed for clinical physicians to continue prescribing IVIG for SFTS patients.
BACKGROUND: Natural Science Foundation of China.
摘要：
背景：严重发热伴血小板减少综合征（SFTS）的最佳治疗策略尚不清楚。我们旨在评估静脉注射免疫球蛋白（IVIG）对SFTS的疗效。
方法：根据第154医院2010-2020年住院的实验室确诊SFTS患者的病历，进行了一项回顾性队列研究。中国。与年龄匹配的1：1倾向得分，性别,从症状发作到入院的间隔，慢性病毒性肝炎的存在，在非IVIG组(支持治疗)和IVIG组(IVIG加支持治疗)之间进行了糖尿病和疾病严重程度.调整匹配变量以比较病死率(CFRs)，两组之间的病毒载量和实验室参数。报告了风险比（RR）和95％置信区间（CI）。
结果：共纳入2219例SFTS患者。IVIG组的1051例患者的CFRs明显高于非IVIG组的1168例患者（19.0％vs.4.6%,RR=4.30，95%CI3.12-5.93）。匹配后差异仍然显着（17.2％与5.1%,RR=4.02，95%CI2.71-5.97）。IVIG组的CFR在各年龄组均显著增高，两个IVIG治疗延迟组和两个治疗持续时间组与非IVIG组比较(均P<0.05)。IVIG治疗与更高的病毒载量和减少的淋巴细胞计数有关，T细胞,血液中CD4+T细胞和自然杀伤细胞(均P<0.05)。
结论：未观察到IVIG在挽救生命或改善SFTS结局方面的明显疗效。临床医生需要谨慎继续为SFTS患者开具IVIG处方。
背景：自然科学基金.
方法：根据第154医院2010-2020年住院的实验室确诊SFTS患者的病历，进行了一项回顾性队列研究。中国。与年龄匹配的1：1倾向得分，性别,从症状发作到入院的间隔，慢性病毒性肝炎的存在，在非IVIG组(支持治疗)和IVIG组(IVIG加支持治疗)之间进行了糖尿病和疾病严重程度.调整匹配变量以比较病死率(CFRs)，两组之间的病毒载量和实验室参数。报告了风险比（RR）和95％置信区间（CI）。
结果：共纳入2219例SFTS患者。IVIG组的1051例患者的CFRs明显高于非IVIG组的1168例患者（19.0％vs.4.6%,RR=4.30，95%CI3.12-5.93）。匹配后差异仍然显着（17.2％与5.1%,RR=4.02，95%CI2.71-5.97）。IVIG组的CFR在各年龄组均显著增高，两个IVIG治疗延迟组和两个治疗持续时间组与非IVIG组比较(均P<0.05)。IVIG治疗与更高的病毒载量和减少的淋巴细胞计数有关，T细胞,血液中CD4+T细胞和自然杀伤细胞(均P<0.05)。
结论：未观察到IVIG在挽救生命或改善SFTS结局方面的明显疗效。临床医生需要谨慎继续为SFTS患者开具IVIG处方。
背景：自然科学基金.
