脑型疟疾中异常视网膜血管的临床-组织病理学相关性
Clinical-histopathological correlation of the abnormal retinal vessels in cerebral malaria.
作者信息
Lewallen S, White V A, Whitten R O, Gardiner J, Hoar B, Lindley J, Lochhead J, McCormick A, Wade K, Tembo M, Mwenechanyana J, Molyneux M E, Taylor T E
机构信息
British Columbia Centre for Epidemiologic and International Ophthalmology, University of British Columbia, 1081 Burrad St, Vancouver, British Columbia, Canada V6Z 1Y6.
出版信息
Arch Ophthalmol. 2000 Jul;118(7):924-8.
BACKGROUND
Clinically abnormal retinal vessels unique to cerebral malaria have previously been shown to be associated with a poor outcome in African children. There have been no studies of the histopathological correlates of these vessels.
DESIGN
This is a descriptive study of the clinical-histopathological correlates of the retinal vessels of 11 children who died with cerebral malaria.
RESULTS
The retinal vessels in children with cerebral malaria contained many parasitized red blood cells; these cells tended to cluster at the periphery of vessels or, in the case of capillaries, to fill the vessel. Those with late-stage parasites had markedly reduced amounts of hemoglobin. The pattern of dehemoglobinization corresponds to the pattern of clinically abnormal vessels.
CONCLUSIONS
The sequestration of late-stage parasitized red blood cells with reduced amounts of hemoglobin accounts for the unique white and pale orange retinal vessels seen in cerebral malaria. Clinical examination of these "marked" vessels offers a method to monitor a basic pathophysiological process of cerebral malaria in vivo. Arch Ophthalmol. 2000;118:924-928
背景
先前已表明，脑型疟疾特有的临床上异常的视网膜血管与非洲儿童的不良预后相关。尚未有关于这些血管的组织病理学相关性的研究。
设计
这是一项对11例死于脑型疟疾的儿童视网膜血管的临床-组织病理学相关性的描述性研究。
结果
脑型疟疾患儿的视网膜血管中含有许多被寄生的红细胞；这些细胞倾向于聚集在血管周边，或者在毛细血管的情况下，充满血管。携带晚期疟原虫的红细胞血红蛋白含量明显降低。血红蛋白脱失模式与临床上异常血管的模式相对应。
结论
晚期被寄生且血红蛋白含量降低的红细胞的滞留，解释了脑型疟疾中独特的白色和淡橙色视网膜血管的出现。对这些“明显的”血管进行临床检查，提供了一种在体内监测脑型疟疾基本病理生理过程的方法。《眼科学文献》。2000年；118:924 - 928
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