Díaz-Quijano F A, Martínez-Vega R A, Villar-Centeno L A
Centro de Investigaciones Epidemiológicas, Facultad de Salud, Universidad Industrial de Santander, Carrera 32 No 29-31, Bucaramanga, Colombia.
Singapore Med J. 2008 Jun;49(6):480-2.
Spontaneous haemorrhage is an important cause of hospitalisation in dengue patients. Early predictors of these complications could help to make opportune decisions.
We prospectively evaluated 51 febrile patients (without previous spontaneous haemorrhage), including 32 cases of dengue fever. Initial evaluation was performed during the first 96 hours after the onset of fever and included complete blood cell count and coagulation tests. Participants were followed-up daily until the seventh day of the disease.
Overall, 15 patients developed spontaneous haemorrhage during the follow-up. Tourniquet test and dengue infection were not associated with haemorrhage (p-value is greater than 0.2). In a logistic regression analysis, platelet count (odds-ratio [OR] 0.78; 95 percent confidence interval [CI] 0.65-0.94) and partial thromboplastin time (OR 1.78; 95 percent CI 1.06-2.99) were independently associated with spontaneous haemorrhage.
Early alterations in platelet count and coagulation test could predict spontaneous bleeding in the acute febrile syndrome.
自发性出血是登革热患者住院的重要原因。这些并发症的早期预测指标有助于做出适时的决策。
我们前瞻性地评估了51例发热患者（既往无自发性出血），其中包括32例登革热患者。在发热开始后的96小时内进行初始评估，包括全血细胞计数和凝血试验。对参与者进行每日随访，直至疾病的第七天。
总体而言，15例患者在随访期间出现自发性出血。束臂试验和登革热感染与出血无关（p值大于0.2）。在逻辑回归分析中，血小板计数（比值比[OR]0.78；95%置信区间[CI]0.65-0.94）和部分凝血活酶时间（OR 1.78；95%CI 1.06-2.99）与自发性出血独立相关。
血小板计数和凝血试验的早期改变可预测急性发热综合征中的自发性出血。
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