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[登革热的临床与流行病学特征]

[Clinical and epidemiological characteristic of dengue].

作者信息

Murillo-Llanes Joel, Soto-Valenzuela Humberto, Flores-Flores Paula, Peraza-Garay Felipe

机构信息

Departamento de Investigación, Hospital General de Culiacán Dr. Bernardo J. Gastélum, Secretaría de Salud, Instituto Mexicano del Seguro Social (IMSS), Navolato, Sinaloa, Mexico.

出版信息

Rev Med Inst Mex Seguro Soc. 2007 Sep-Oct;45(5):485-91.

Abstract

OBJECTIVE

To describe the clinical and epidemiological characteristics of dengue fever (DF) and dengue hemorrhagic fever (DHF).

MATERIAL AND METHODS

A cross-sectional study was conducted in the Hospital General de Culiacan Dr. Bernardo J. Gastélum and the Hospital General de Zona 28 of IMSS from September to November 2003, with patients having dengue diagnosis, which was classified according to the WHO criteria. The statistical program Stata v6 was used for the analysis.

RESULTS

231 dengue cases (DF: 90.48 %; DHF 9.52 %) were included. Average age was 34.5 +/- 15 years. 61.7% of DF cases were women, while 77.3% of DHF cases were men. DHF cases went to the hospital in 4.7 +/- 2 days, while DF cases went in 3.4 +/- 2.2 days (p = 0.004). DHF cases had more often headache, retroocular pain, arthralgias, diarrhea and vomiting (p < 0.05). DF cases showed hemorrhagic manifestations (24.8%); plasma leakage (6.7%) and thrombocytopenia (34.4%); petequiae, gingival bleeding and epistaxis were associated to thrombocytopenia below 39 000/mm(3) (p < 0.05); neutropenia, prolonged partial thromboplastin time elevated transaminases were observed more often in DHF cases (p <0.05).

CONCLUSIONS

the main variables associated with DHF were: male gender, fever, vomiting and gingival bleeding but not previous history of dengue; the major hemoconcentration, the major severity of thrombocytopenia.

摘要

目的

描述登革热(DF)和登革出血热(DHF)的临床及流行病学特征。

材料与方法

于2003年9月至11月在库利亚坎市贝纳多·J·加斯特卢姆综合医院及墨西哥社会保障局第28区综合医院开展了一项横断面研究,研究对象为诊断为登革热的患者,根据世界卫生组织标准进行分类。采用统计软件Stata v6进行分析。

结果

共纳入231例登革热病例(登革热:90.48%;登革出血热:9.52%)。平均年龄为34.5±15岁。登革热病例中61.7%为女性,而登革出血热病例中77.3%为男性。登革出血热病例在发病4.7±2天就医,而登革热病例在发病3.4±2.2天就医(p = 0.004)。登革出血热病例更常出现头痛、眼球后疼痛、关节痛、腹泻和呕吐(p < 0.05)。登革热病例出现出血表现(24.8%);血浆渗漏(6.7%)和血小板减少(34.4%);血小板计数低于39000/mm³时,瘀点、牙龈出血和鼻出血与血小板减少相关(p < 0.05);登革出血热病例更常出现中性粒细胞减少、部分凝血活酶时间延长和转氨酶升高(p < 0.05)。

结论

与登革出血热相关的主要变量为:男性、发热、呕吐和牙龈出血,但与既往登革热病史无关;血液浓缩更明显,血小板减少更严重。

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