Erhart Laura M, Yingyuen Kritsanai, Chuanak Niphon, Buathong Nilawan, Laoboonchai Anintita, Miller R Scott, Meshnick Steven R, Gasser Robert A, Wongsrichanalai Chansuda
Department of Immunology and Medicine, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.
Am J Trop Med Hyg. 2004 Jan;70(1):8-14.
This study examines hematologic profiles of persons with acute Plasmodium falciparum or P. vivax infection in Maesod on Thailand's western border with Myanmar compared with febrile, non-parasitemic persons also reporting to malaria clinics. Nine hundred seventy-nine subjects were malaria-negative, 414 were infected with P. falciparum, and 646 were infected with P. vivax. Persons with patent parasitemia tended to have significantly lower white blood cell, red blood cell, platelet, and hemoglobin levels than those who were malaria-negative. For the first time, a parallel trend in thrombocytopenia with parasitemia was found to be associated with both P. falciparum, and P. vivax infection. Using logistic regression, persons with platelet counts < 150,000/microL were 12-15 times more likely to have malaria than persons with platelet counts > or = 150,000/microL. This study supplements previous literature on the hematologic effects of malaria and helps define those alterations for a semi-immune population. Thrombocytopenia is identified as a key indicator of malaria in these febrile patients.
本研究调查了泰国与缅甸西部接壤的湄索地区急性恶性疟原虫或间日疟原虫感染者的血液学特征，并与同样前往疟疾诊所就诊的发热但无寄生虫血症的患者进行了比较。979名受试者疟疾检测呈阴性，414名感染恶性疟原虫，646名感染间日疟原虫。有明显寄生虫血症的患者，其白细胞、红细胞、血小板和血红蛋白水平往往显著低于疟疾检测呈阴性的患者。首次发现血小板减少症与寄生虫血症的平行趋势与恶性疟原虫和间日疟原虫感染均有关。使用逻辑回归分析，血小板计数<150,000/微升的患者患疟疾的可能性是血小板计数≥150,000/微升患者的12至15倍。本研究补充了先前关于疟疾血液学影响的文献，并有助于确定半免疫人群的这些改变。血小板减少症被确定为这些发热患者疟疾的关键指标。
