Study on the early predictive value of alkaline phosphatase and interleukin-8 for severe patients with severe fever with thrombocytopenia syndrome

doi:10.19871/j.cnki.xfcrbzz.2025.01.010

Abstract

Abstract: Objective Multiple blood indicators were analyzed to find the indicators with early prediction value for severe patients with severe fever with thrombocytopenia syndrome (SFTS), and a joint prediction model was constructed to provide evidence for early clinical intervention of severe SFTS. Method A total of 98 SFTS inpatients from Nanjing Second Hospital were retrospectively included from April 2023 to July 2024. According to whether complications arose during treatment, they were divided into the severe SFTS group (33 cases) and the mild SFTS group (65 cases). Collecting the blood indicators of patients tested for the first time after admission, and analyzing the differences of blood indicators between the two groups. Blood indicators with significant differences were used to build a joint prediction model. ROC curve was used to evaluate the early predictive value of blood indicators for severe SFTS. Hosmer-Lemeshow test and decision curve were used to evaluate the calibration and clinical applicability of the joint prediction model, respectively. Result B-type natriuretic peptide, D-dimer, activated partial thromboplastin time, α-hydroxybutyrate dehydrogenase, glutamyl transpeptidase, alanine aminotransferase, mitochondrial aspartate aminotransferase/aspartate aminotransferase, aspartate aminotransferase, mitochondrial aspartate aminotransferase, alkaline phosphatase, creatine phosphokinase, lactate dehydrogenase, interferon-γ (IFN-γ), interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10) and procalcitonin in the severe SFTS group were significantly higher than those in the mild SFTS group, while albumin, CD3⁺T cells, CD4⁺T cells and CD8⁺T cells in the severe SFTS group were significantly lower than those in the mild SFTS group (all P<0.05). Multivariable analysis showed the increased levels of alkaline phosphatase [OR=1.029 (95%CI: 1.005-1.054), P=0.019] and IL-8 [OR=1.005 (95%CI: 1.001-1.009), P=0.026] were risk factors for severe SFTS. ROC curve analysis showed that the joint prediction model has good predictive value for severe SFTS (AUC=0.893), and the joint prediction model had good calibration and clinical applicability. Conclusion The joint prediction model based on blood indicators had high value and clinical applicability for early predicting severe SFTS, which can help clinicians to early predict patients with severe SFTS and to perform timely individualized treatment.

Key words: Severe fever with thrombocytopenia syndrome, Novel bunyavirus, Severity, Blood indicators, Joint prediction model, Early prediction

CLC Number:

R512.8

Xu Tan, Zhou Nan, Hu Qinqin, Xiao Yuanyuan, Zhang Mi, Li Jinlong. Study on the early predictive value of alkaline phosphatase and interleukin-8 for severe patients with severe fever with thrombocytopenia syndrome[J]. Electronic Journal of Emerging Infectious Diseases, 2025, 10(1): 50-55.

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