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患有美洲内脏利什曼病的儿童和成人在临床和实验室参数上是否存在差异?

Are there differences in clinical and laboratory parameters between children and adults with American visceral leishmaniasis?

作者信息

Caldas Arlene J M, Costa Jackson, Aquino Dorlene, Silva Antônio Augusto M, Barral-Netto Manoel, Barral Aldina

机构信息

Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz (FIOCRUZ), Salvador, BA, Brazil.

出版信息

Acta Trop. 2006 Mar;97(3):252-8. doi: 10.1016/j.actatropica.2005.09.010. Epub 2006 Jan 18.

Abstract

A prospective study on 23 patients with American visceral leishmaniasis (VL), comparing clinical and laboratory parameters of 14 children (mean age of 3.85+/-3.39 years) to nine adults (27.4+/-10.90 years) was performed in São Luís, Maranhão, Brazil, between August 2000 and July 2002. Data were collected at entrance (day 0), end of treatment, as well as 120 and 210 days after treatment using a protocol chart containing patient identification, clinical and laboratory data. N-Methylglucamine antimonate administered at the dose of 20mg/Sb5+/kg/day for 20-30 days was successfully used in all patients. Patients were followed for 1 year after treatment, and no relapses were observed. A prolonged duration of the disease, lymphadenopathy and bleeding predominated in adult patients, while hepatomegaly and skin-mucosal pallor were more frequent in children. Disease was longer and more severe in adults than in children. Although both groups exhibited a trend toward normalization of hematological and biochemical parameters, more children returned sooner to normal values than adults. Difference in clinical or laboratory parameters between children and adults did not indicate the need for different clinical or therapeutic approaches.

摘要

2000年8月至2002年7月期间,在巴西马拉尼昂州圣路易斯市对23例美洲内脏利什曼病(VL)患者进行了一项前瞻性研究,比较了14名儿童(平均年龄3.85±3.39岁)和9名成人(27.4±10.90岁)的临床和实验室参数。使用包含患者识别、临床和实验室数据的方案图表,在入院时(第0天)、治疗结束时以及治疗后120天和210天收集数据。所有患者均成功使用了剂量为20mg/Sb5+/kg/天、持续20 - 30天的葡甲胺锑酸盐。治疗后对患者进行了1年的随访,未观察到复发情况。成年患者中疾病持续时间延长、淋巴结病和出血更为突出,而儿童中肝肿大和皮肤黏膜苍白更为常见。成人的疾病比儿童的更长且更严重。尽管两组的血液学和生化参数均有趋于正常的趋势,但儿童比成人更快恢复到正常水平。儿童和成人在临床或实验室参数上的差异并不表明需要不同的临床或治疗方法。

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