Carlos Celia C, Oishi Kazunori, Cinco Maria T D D, Mapua Cynthia A, Inoue Shingo, Cruz Deu John M, Pancho Mary Ann M, Tanig Carol Z, Matias Ronald R, Morita Kouichi, Natividad Filipinas F, Igarashi Akira, Nagatake Tsuyoshi
Department of Pediatrics, and Research and Biotechnology Division, St. Luke's Medical Center, Quezon City, The Philippines.
Am J Trop Med Hyg. 2005 Aug;73(2):435-40.
To demonstrate the differences of clinical features and hematologic abnormalities between dengue fever (DF) and dengue hemorrhagic fever (DHF), 359 pediatric patients admitted St. Luke's Medical Center in Quezon City, between 1999 and 2001 in Metro Manila, and adjoining provinces the Philippines, with a laboratory-confirmed dengue virus infection were evaluated. One third of the patients had DHF, and most of these patients were without shock. Restlessness, epistaxis, and abdominal pain were more associated with DHF. The platelet count was significantly lower in the DHF group than in the DF group before and after defervescence. In the DHF patients, the hematocrit was significantly increased before defervescence, and decreased the day after due to administration of intravenous fluid. Coagulation abnormalities associated with most DHF patients were thrombocytopenia and an increased fibrinolysis, but not disseminated intravascular coagulation. We present recent data on readily obtained clinical and laboratory data that can be used for early diagnosis and consequently earlier appropriate treatment of dengue virus infections.
为了阐明登革热(DF)和登革出血热(DHF)之间临床特征和血液学异常的差异,我们对1999年至2001年期间在菲律宾马尼拉大都会奎松市圣卢克医疗中心以及邻近省份住院的359例经实验室确诊为登革病毒感染的儿科患者进行了评估。三分之一的患者患有DHF,且这些患者大多数无休克表现。烦躁不安、鼻出血和腹痛与DHF的相关性更强。在退热前后,DHF组的血小板计数均显著低于DF组。在DHF患者中,退热前血细胞比容显著升高,而在退热次日因静脉补液而降低。与大多数DHF患者相关的凝血异常为血小板减少和纤维蛋白溶解增加,但无弥散性血管内凝血。我们展示了关于易于获得的临床和实验室数据的最新资料,这些数据可用于登革病毒感染的早期诊断以及随后的早期适当治疗。