Analysis For The Risk Factors Of Severe And Bacterial Infection In Patients With Hemorrhagic Fever With Renal Syndrome

Objective : To explore the risk factors of severity and bacterial infection in patients with hemorrhagic fever with renal syndrome(HFRS)and to help timely determine the condition and guide treatment.Methods:The 150 patients with HFRS admitted to the Infectious Department of the First Affiliated Hospital of Nanchang University from January 2016 to January2018 were selected as the research objects.The clinical and laboratory data were retrospectively analyzed.According to the clinical classification criteria of HFRS,the light type and middle type was recorded as mild group,and the severe and critical type was recorded as severe group.According to clinical manifestations combined with imaging,serology,etiology,HFRS patients can be divided into infected group and non-infected group.Results:1.Analysis of the characteristics of mild and severe group in patients with HFRSThere were 85 cases in the mild group and 65 cases in the severe group.There was no significant difference in age and gender between the two groups(P>0.05),but there were differences in white blood cells,procalcitonin,C-reactive protein,creatinine,urea,and infection(P < 0.05).Multivariate logistic regression analysis showed that procalcitonin(OR=2.151,95%CI 1.445-3.201,P<0.001)and creatinine(OR=13.052,95%CI 3.769-45.196,P<0.001)were independently associated with the severity of the disease,the area under the ROC curve(AUC)of procalcitonin and creatinine diagnosing the severity of HFRS was 0.728(95%CI 0.647-0.809,P<0.001)and 0.785(95%CI 0.707-0.863,P<0.001),respectively.The combination of procalcitonin and creatinine diagnosing the severity of HFRS was 0.821,95% CI was0.751-0.890,P < 0.001.2.Analysis of the characteristics of infected and non-infected groups in patients with HFRSThere were 81 cases in the infected group and 69 cases in the non-infected group.There was no significant difference in age and gender between the two groups(P>0.05),but there were differences in in C-reactive protein,procalcitonin,creatinine and urea(P < 0.05).Multivariate logistic regression analysis showed that procalcitonin was independently associated with bacterial infection of HFRS(OR=1.581,95% CI1.177-2.122,P=0.002),and the AUC for diagnosing bacterial infection of HFRS was0.645(95%CI 0.557-0.732,P=0.002).Conclusion : Procalcitonin and creatinine are risk factors for the severity of patients with HFRS,and have diagnostic value for the severity of HFRS.Procalcitonin combined with creatinine is more valuable in the diagnosis of HFRS severity.Procalcitonin is a high risk influencing risk factor for bacterial infection in patients with HFRS and has a diagnostic value for bacterial infection in patients with HFRS.