Villar-Centeno Luis Angel, Díaz-Quijano Fredi Alexander, Martínez-Vega Ruth Aralí
School of Medicine, and Centro de Investigaciones Epidemiológicas, Universidad Industrial de Santander, Bucaramanga, Colombia.
Am J Trop Med Hyg. 2008 Mar;78(3):370-4.
We evaluated biochemical alterations as predictors of dengue hemorrhagic fever (DHF). Patients with confirmed infection with dengue virus were prospectively evaluated for the first seven days of disease to determine their final clinical outcome. Serum samples taken 48-96 hours after onset of fever were used for biochemical tests. Of 199 patients, 30 developed DHF. Cases of DHF had higher levels of lactate dehydrogenase (LDH), creatine kinase (CK), and aspartate aminotransferase, and lower levels of albumin, total cholesterol, and triglycerides. Multivariate analysis showed that early alterations of CK (hazard ratio [HR] = 6.98, 95% confidence interval [CI] = 2.34-20.85, P = 0.001), LDH (HR = 3.19, 95% CI = 1.01-10.12, P < 0.05), and albumin (HR = 2.54, 95% CI = 1.09-5.92, P = 0.03) were associated with DHF. Triglyceride levels > 160 mg/dL were negatively associated with developing DHF (HR = 0.07, 95% CI = 0.01-0.59, P = 0.01). Early alterations of biochemical markers can predict DHF in patients with acute fever caused by dengue.
我们评估了生化改变作为登革出血热（DHF）预测指标的情况。对确诊感染登革病毒的患者在疾病的前七天进行前瞻性评估，以确定其最终临床结局。发热开始后48 - 96小时采集的血清样本用于生化检测。在199例患者中，30例发展为DHF。DHF病例的乳酸脱氢酶（LDH）、肌酸激酶（CK）和天冬氨酸转氨酶水平较高，而白蛋白、总胆固醇和甘油三酯水平较低。多因素分析显示，CK早期改变（风险比[HR]=6.98，95%置信区间[CI]=2.34 - 20.85，P = 0.001）、LDH（HR = 3.19，95%CI = 1.01 - 10.12，P < 0.05）和白蛋白（HR = 2.54，95%CI = 1.09 - 5.92，P = 0.03）与DHF相关。甘油三酯水平>160 mg/dL与发生DHF呈负相关（HR = 0.07，95%CI = 0.01 - 0.59，P = 0.01）。生化标志物的早期改变可预测登革热引起的急性发热患者是否会发生DHF。
