Correlation Between Serum Ferritin And Disease Status In Patients With Fever During Dengue Fever

Objective: To investigate the clinical significance of Serum Ferritin(SF)in patients with fever of Dengue Fever(DF)and its possible mechanism.Methods: A retrospective analysis of 171 patients diagnosed with dengue fever(range <7 days,T> 37.3℃)at The Affiliated Hospital of Hangzhou Normal University from July 2017 to December 2018 was performed in the dengue group and 130 healthy patients were used as the control group.Collect general clinical data and SF,CRP,liver function related indicators(ALT,AST,TBIL,ALB,ALP),blood routine indicators(WBC,PLT)of the two groups,describe liver injury and thrombocytopenia in dengue patients,and analyze SF Relevance to them.According to the guidelines for the diagnosis and treatment of dengue fever,the patients in the dengue fever group were divided into severe early warning dengue fever group and ordinary dengue fever group,and the differences in SF levels between the two groups were compared.Binary logistic regression analysis of risk factors and ROC curve analysis of SF prediction of severe dengue fever were performed.In addition,the SF levels of patients with different lengths of hospitalization were compared early in the course of the disease to evaluate the prognostic value of SF for the disease.Results: There was no significant difference in age,gender,and CRP between the dengue fever group and the control group.Compared with the control group,the levels of ALT,AST,and SF in the dengue fever group were significantly increased(Z= 11.553,15.054,and 15.163,all P< 0.001),WBC,PLT decreased(t= 14.254 and 21.855,both P<0.001),suggesting that patients with dengue fever can have liver damage,thrombocytopenia and elevated SF levels early in the course of the disease;the study found that dengue fever with liver damage group The SF level of patients was significantly higher than that of patients without liver damage(Z= 6.930,P <0.001),and there was no statistical difference in age,gender,peak temperature,and history of liver disease(P> 0.05).In addition,Spearman correlation analysis showed that: SF was positively correlated with ALT,AST,and TBIL(r= 0.464,0.531,and 0.315,all P<0.001),negatively correlated with platelets(r =-0.355,P = 0.004),and had no significan correlation with WBC and ALB(P> 0.05);ALT,AST,PLT levels and liver damage rates were statistically different in patients with dengue fever with different SF levels(H = 14.240 and 17.584,F= 11.754,c2 = 49.547,P<0.001),higher Patients with SF levels have ALT,AST levels,and liver damage Incidence rates increased and PLT decreased(all P<0.05);Compared with ordinary dengue fever,the SF level in patients with severe early warning dengue fever was significantly increased(Z= 4.566,P <0.001);Dichotomous logistic multiple regression suggests that hyperferritinemia(SF≥500ng/ml)is a risk of dengue fever with liver damage and severe early warning dengue Risk factors(OR= 8.120 and 16.420,P <0.001),and ROC curve analysis showed that SF predicts the AUC of severe early warning dengue patients is 0.831(95% CI: 0.772-0.891),and the cutoff value is 1510 ng / ml,the sensitivity was 78.3% and the specificity was 74.7%.According to the median length of stay of 7 days,the patients were divided into 2 groups.The ferritin level of patients with long hospital stay(≥ 7days)was 2278(908,5037)ng/m L,which was significantly greater than that of patients with short hospital stay(<7days).1343(584,2450)ng/m L,the difference was statistically significant(Z= 4.566,P<0.001).In addition,spearman correlation analysis showed that there was a positive correlation between SF and length of hospital stay(r = 0.243,P = 0.001).Conclusion: SF levels in patients with acute fever of dengue fever have certain correlation with liver injury,thrombocytopenia,disease status and prognosis,which has certain reference value for clinicians in early diagnosis and treatment of dengue fever.