间日疟原虫疟疾中黄疸的发病率：印度南部穆达比德里的一项前瞻性研究。

Incidence of Jaundice in Plasmodium vivax Malaria: A Prospective Study in Moodabidri, South India.

作者信息

Naik Bolar Sadananda

机构信息

Department of Internal Medicine, Alva's Health Centre, Moodabidri - 574227, Karnataka, India.

出版信息

Malays J Med Sci. 2014 Jul;21(4):24-7.

PMID:25977618

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4418110/

Abstract

BACKGROUND

A prospective study was taken to look for the incidence of jaundice in Plasmodium vivax malaria patients in Moodabidri, a coastal town of South India.

METHODS

A prospective study was conducted in the patients admitted with the diagnosis of Plasmodium vivax malaria at the Alva's health centre, during study period 1st Jun 2011 to 10th October 2012. Bilirubin levels were checked in all the selected patients. Patients who had their total bilirubin level 3.0 mg% or more were considered to be having jaundice and were further tested for anemia and hepatic dysfunction by carrying out hemoglobin (Hb), serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), surface antigen of the hepatitis B virus (HBsAg). The data collected were analysed statistically.

RESULTS

A total of 188 patients who had Plasmodium vivax malaria as diagnosed by peripheral blood film (PBF) and rapid diagnostic test (RDT) were included in the study. Jaundice was present in 19 (10.1%) patients and the mean (SD) level of serum bilirubin was 4.5 mg/dL (2.4) (maximum = 12.7 mg %) with 94.7% (n = 18) of the patients having predominantly indirect type or unconjugated hyperbilirubinemia. The hepatic dysfunction was present in 15 (78.9%) with mean (SD) level of aspartate aminotransferase (AST) was 61.57 IU/L (SD 33.8) (maximum = 160 IU/L) and alanine aminotransferase (ALT) was 54.8 IU/L (SD 21.2) (maximum = 108 IU/L). Anemia was present in 3 (15.8%) patients and the mean hemoglobin level was 12.8 gm/dL (SD 1.8) (minimum = 6.4 gm/dL). Out of 19 patients who had jaundice majority were males (94.7 %, n = 18) and only one female (5.3%, n = 1) was found to be having jaundice. The age of the patients who had jaundice ranged from 17 to 60 years 29 years (SD 13.7).

CONCLUSION

This study has further reiterated the fact that Plasmodium vivax malaria is no longer a "benign" disease and it can also produce jaundice, hepatic dysfunction, and anemia.

摘要

背景

在印度南部沿海城镇穆达比德里，开展了一项前瞻性研究，以探寻间日疟原虫疟疾患者中黄疸的发病率。

方法

于2011年6月1日至2012年10月10日研究期间，在阿尔瓦健康中心对确诊为间日疟原虫疟疾的患者进行了一项前瞻性研究。对所有选定患者检查胆红素水平。总胆红素水平达到3.0mg%或更高的患者被视为患有黄疸，并通过检测血红蛋白（Hb）、血清谷草转氨酶（SGOT）、血清谷丙转氨酶（SGPT）、乙肝病毒表面抗原（HBsAg）进一步检查是否贫血和肝功能障碍。对收集的数据进行统计学分析。

结果

共有188例经外周血涂片（PBF）和快速诊断试验（RDT）确诊为间日疟原虫疟疾的患者纳入研究。19例（10.1%）患者出现黄疸，血清胆红素平均（标准差）水平为4.5mg/dL（2.4）（最高 = 12.7mg%），94.7%（n = 18）的患者主要为间接型或非结合性高胆红素血症。15例（78.9%）患者存在肝功能障碍，天冬氨酸转氨酶（AST）平均（标准差）水平为61.57IU/L（标准差33.8）（最高 = 160IU/L），丙氨酸转氨酶（ALT）为54.8IU/L（标准差21.2）（最高 = 108IU/L）。3例（15.8%）患者存在贫血，平均血红蛋白水平为12.8g/dL（标准差1.8）（最低 = 6.4g/dL）。19例黄疸患者中，大多数为男性（94.7%，n = 18），仅1名女性（5.3%，n = 1）出现黄疸。出现黄疸的患者年龄在17至60岁之间，平均29岁（标准差13.7）。