Ladhani Shamez, Lowe Brett, Cole Andrew O, Kowuondo Ken, Newton Charles R J C
Centre for Geographical Medicine Research (Coast), Kenya Medical Research Institute, Kilifi, Kenya.
Br J Haematol. 2002 Dec;119(3):839-47. doi: 10.1046/j.1365-2141.2002.03904.x.
Little is known about the changes in white blood cells and platelets in children with falciparum malaria in endemic areas. We measured the white cell count (WCC) and platelets of 230 healthy children from the community, 1369 children admitted to hospital with symptomatic malaria, and 1461 children with other medical conditions. Children with malaria had a higher WCC compared with community controls, and leucocytosis was strongly associated with younger age, deep breathing, severe anaemia, thrombocytopenia and death. The WCC was not associated with a positive blood culture. In children with malaria, high lymphocyte and low monocyte counts were independently associated with mortality. A platelet count of less than 150 x 109/l was found in 56.7% of children with malaria, and was associated with age, prostration and parasite density, but not with bleeding problems or mortality. The mean platelet volume was also higher in children with malaria compared with other medical conditions. This may reflect early release from the bone marrow in response to peripheral platelet destruction. Thus, leucocytosis was associated with both severity and mortality in children with falciparum malaria, irrespective of bacteraemia, whereas thrombocytopenia, although very common, was not associated with adverse outcome.
关于流行地区患恶性疟原虫疟疾儿童的白细胞和血小板变化，人们了解甚少。我们测量了230名来自社区的健康儿童、1369名因有症状疟疾入院的儿童以及1461名患有其他疾病的儿童的白细胞计数（WCC）和血小板。与社区对照组相比，患疟疾的儿童白细胞计数更高，白细胞增多与年龄较小、深呼吸、严重贫血、血小板减少和死亡密切相关。白细胞计数与血培养阳性无关。在患疟疾的儿童中，高淋巴细胞计数和低单核细胞计数与死亡率独立相关。56.7%的患疟疾儿童血小板计数低于150×10⁹/L，且与年龄、极度虚弱和寄生虫密度有关，但与出血问题或死亡率无关。与患有其他疾病的儿童相比，患疟疾儿童的平均血小板体积也更高。这可能反映了骨髓对外周血小板破坏的早期反应而释放。因此，白细胞增多与恶性疟原虫疟疾儿童的病情严重程度和死亡率均相关，无论是否存在菌血症，而血小板减少虽然非常常见，但与不良结局无关。
