血清 C 反应蛋白和总胆红素水平在鉴别归国旅行者中登革热和疟疾的作用。
The usefulness of serum C-reactive protein and total bilirubin levels for distinguishing between dengue fever and malaria in returned travelers.
机构信息
National Center for Global Health and Medicine, Disease Control and Prevention Center, Tokyo, Japan.
出版信息
Am J Trop Med Hyg. 2014 Mar;90(3):444-8. doi: 10.4269/ajtmh.13-0536. Epub 2014 Jan 13.
The clinical manifestations of dengue fever (DF) and malaria are similar. Specific diagnostic tests are not always available. A retrospective study to compare the laboratory results of malaria and DF was conducted at the National Center for Global Health and Medicine in Japan from January of 2005 to March of 2013. Febrile returned travelers from overseas diagnosed with malaria or DF were included; 86 malaria and 85 DF cases were identified. C-reactive protein (CRP) and total bilirubin (T-bil) had high area under the receiver operating characteristic curves (> 0.9). A cutoff value of CRP > 2.4 mg/dL to predict malaria as opposed to DF had a sensitivity of 91.9% (95% confidence interval [95% CI] = 83.9-96.7%) and specificity of 90.6% (95% CI = 82.3-95.8%). A cutoff value of T-bil > 0.9 mg/dL to predict malaria as opposed to DF had a sensitivity of 73.8% (95% CI = 62.7-83%) and a specificity of 95.1% (95% CI = 88-98.6%). CRP and T-bil are useful to distinguish between DF and malaria in returned travelers.
登革热（DF）和疟疾的临床表现相似，并非总能进行特定的诊断性检测。本研究回顾性分析了 2005 年 1 月至 2013 年 3 月在日本国立全球卫生与医学研究中心就诊的、来自海外且发热的旅行者，比较了疟疾和 DF 的实验室结果，共纳入 86 例疟疾患者和 85 例 DF 患者。C 反应蛋白（CRP）和总胆红素（T-bil）的受试者工作特征曲线下面积（AUC）均较高（＞0.9）。CRP＞2.4 mg/dL 时预测疟疾而非 DF 的敏感性为 91.9%（95%可信区间[95%CI]：83.9-96.7%），特异性为 90.6%（95%CI：82.3-95.8%）；T-bil＞0.9 mg/dL 时预测疟疾而非 DF 的敏感性为 73.8%（95%CI：62.7-83%），特异性为 95.1%（95%CI：88-98.6%）。CRP 和 T-bil 有助于鉴别来自海外的发热旅行者中 DF 和疟疾。
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