Wiwanitkit Viroj, Manusvanich Pornake
Department of Laboratory Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Clin Appl Thromb Hemost. 2004 Jan;10(1):65-7. doi: 10.1177/107602960401000111.
Dengue infection is a major public health problem, affecting children in the Southeast Asia region. In Thailand, the dengue hemorrhagic fever is still a major infectious disease among the children with up to two to three epidemics per year. Hemoconcentration accompanied by platelet depletion are the predominant laboratory signs of dengue hemorrhagic fever. Findings from 23 hospitalized patients with dengue hemorrhafic fever in a small outbreak in a provincial hospital in Thailand are reported. The question if hematocrit and platelet determination on admission can predict shock in hospitalized children with dengue hemorrhagic fever was studied. The data from the discharge summary of these patients were studied, focusing on the admission hematology laboratory data. Regression analysis was used to test the correlation between the admission hematology laboratory data (hematocrit, white blood cell count, and platelet) and the focused outcome (shock or no shock). Of these 23 patients, shock did not develop in 19, and shock developed in four. There was no significant difference in admission hematology laboratory data between both groups (p < 0.05). The regression analysis revealed no significant correlation between the studied hematology laboratory data and the focused outcome (p > 0.05). It means that the three studied investigations on admission cannot predict shock in our hospitalized dengue hemorrhagic cases. From this study, it can imply that closed monitoring of dengue hemorrhagic patients is necessary. The general practitioner cannot rely on the admission hematology laboratory data to predict shock in these patients. Additionally, it might confirm that, although dengue infection can be fatal, with proper supportive treatment, especially hospitalization and hydration for severe cases, the outcome is very good.
登革热感染是一个主要的公共卫生问题，影响东南亚地区的儿童。在泰国，登革出血热仍然是儿童中的一种主要传染病，每年多达两到三次流行。血液浓缩伴血小板减少是登革出血热的主要实验室指标。报告了泰国一家省级医院一次小范围暴发中23例住院登革出血热患者的情况。研究了入院时血细胞比容和血小板测定能否预测住院登革出血热患儿发生休克的问题。对这些患者出院小结的数据进行了研究，重点关注入院时血液学实验室数据。采用回归分析来检验入院时血液学实验室数据（血细胞比容、白细胞计数和血小板）与重点观察结果（休克或未休克）之间的相关性。这23例患者中，19例未发生休克，4例发生休克。两组入院时血液学实验室数据无显著差异（p<0.05）。回归分析显示，所研究的血液学实验室数据与重点观察结果之间无显著相关性（p>0.05）。这意味着所研究的三项入院检查不能预测我们住院登革出血热病例中的休克情况。从这项研究可以推断，对登革出血热患者进行密切监测是必要的。全科医生不能依靠入院时的血液学实验室数据来预测这些患者是否会发生休克。此外，这可能证实，尽管登革热感染可能致命，但通过适当的支持性治疗，尤其是对重症病例进行住院治疗和补液，预后非常好。
