Schexneider Katherine I, Reedy Edward A
Medical Corps, US Navy, Department of Laboratory Medicine, Georgetown University Hospital, 3800 Reservoir Road, Room 1321, Washington, DC 20007, USA.
Curr Hematol Rep. 2005 Mar;4(2):145-8.
Dengue is probably the most important arthropod-borne viral disease in terms of human morbidity and mortality. We review the pathophysiology of thrombocytopenia and clinical bleeding in dengue across the spectrum of disease. The mechanisms of thrombocytopenia and coagulopathy are complex, involving platelet activation, procoagulant and anticoagulant arms of the coagulation system, complement, cytokines, and endothelial cells. Platelet counts do not correlate well with clinical bleeding. Although serious bleeding is rare, patients should be monitored closely for hemorrhagic manifestations and thrombocytopenia. Symptomatic thrombocytopenia may require platelet transfusion.
就人类发病率和死亡率而言，登革热可能是最重要的节肢动物传播病毒性疾病。我们综述了登革热全病程中血小板减少和临床出血的病理生理学。血小板减少和凝血病的机制复杂，涉及血小板活化、凝血系统的促凝和抗凝分支、补体、细胞因子及内皮细胞。血小板计数与临床出血情况相关性不佳。尽管严重出血罕见，但仍应密切监测患者的出血表现和血小板减少情况。有症状的血小板减少可能需要输注血小板。
