The US Navy Medical Research Unit no. 2, Jakarta, Indonesia.
Malar J. 2008 Dec 18;7:259. doi: 10.1186/1475-2875-7-259.
There are limited data on the evolution of the leukocyte and platelet counts in malaria patients.
In a clinical trial of chloroquine vs. chloroquine plus doxycycline vs. doxycycline alone against Plasmodium vivax (n = 64) or Plasmodium falciparum (n = 98) malaria, the total white cell (WCC) and platelet (PLT) counts were measured on Days 0, 3, 7 and 28 in 57 indigenous Papuans with life long malaria exposure and 105 non Papuan immigrants from other parts of Indonesia with limited malaria exposure.
The mean Day 0 WCC (n = 152) was 6.492 (range 2.1-13.4) x 10(9)/L and was significantly lower in the Papuans compared to the non Papuans: 5.77 x 10(9)/L vs. 6.86 x 10(9)/L, difference = -1.09 [(95% CI -0.42 to -1.79 x 10(9)/L), P = 0.0018]. 14 (9.2%) and 9 (5.9%) patients had leukopaenia (<4.0 x 10(9)/L) and leukocytosis (>10.0 x 10(9)/L), respectively. By Day 28, the mean WCC increased significantly (P = 0.0003) from 6.37 to 7.47 x 10(9)/L (73 paired values) and was similar between the two groups. Ethnicity was the only WCC explanatory factor and only on Day 0.The mean Day 0 platelet count (n = 151) was 113.0 (range 8.0-313.0) x 10(9)/L and rose significantly to 186.308 x 10(9)/L by Day 28 (P < 0.0001). There was a corresponding fall in patient proportions with thrombocytopaenia (<150 x 10(9)/L): 119/151 (78.81%) vs. 16/73 (21.92%, P < 0.00001). Papuan and non Papuan mean platelet counts were similar at all time points. Only malaria species on Day 0 was a significant platelet count explanatory factor. The mean D0 platelet counts were significantly lower (P = 0.025) in vivax (102.022 x 10(9)/L) vs. falciparum (122.125 x 10(9)/L) patients.
Changes in leukocytes and platelets were consistent with other malaria studies. The Papuan non Papuan difference in the mean Day 0 WCC was small but might be related to the difference in malaria exposure.
有关疟疾患者白细胞和血小板计数变化的数据有限。
在一项氯喹与氯喹加强力霉素与强力霉素单独治疗间日疟原虫(n = 64)或恶性疟原虫(n = 98)疟疾的临床试验中,57 名长期患有疟疾的巴布亚土着人和 105 名来自印度尼西亚其他地区、疟疾暴露有限的非巴布亚移民在第 0、3、7 和 28 天测量了总白细胞(WCC)和血小板(PLT)计数。
第 0 天的平均 WCC(n = 152)为 6.492(范围 2.1-13.4)x 10(9)/L,巴布亚人的 WCC 明显低于非巴布亚人:5.77 x 10(9)/L 与 6.86 x 10(9)/L,差异=-1.09 [(95%CI -0.42 至-1.79 x 10(9)/L),P = 0.0018]。分别有 14 名(9.2%)和 9 名(5.9%)患者白细胞减少症(<4.0 x 10(9)/L)和白细胞增多症(>10.0 x 10(9)/L)。到第 28 天,WCC 显著增加(P = 0.0003),从 6.37 增加到 7.47 x 10(9)/L(73 对配对值),两组间相似。种族是唯一的 WCC 解释因素,仅在第 0 天。第 0 天的平均血小板计数(n = 151)为 113.0(范围 8.0-313.0)x 10(9)/L,到第 28 天显著升高至 186.308 x 10(9)/L(P <0.0001)。血小板减少症(<150 x 10(9)/L)患者的比例相应下降:119/151(78.81%)与 16/73(21.92%,P <0.00001)。巴布亚人和非巴布亚人的平均血小板计数在所有时间点均相似。仅在第 0 天的疟疾种类是血小板计数的显著解释因素。间日疟原虫(102.022 x 10(9)/L)患者的平均 D0 血小板计数明显低于恶性疟原虫(122.125 x 10(9)/L)患者(P = 0.025)。
白细胞和血小板的变化与其他疟疾研究一致。巴布亚人和非巴布亚人在第 0 天的平均 WCC 差异较小,但可能与疟疾暴露的差异有关。