Andries Anne-Claire, Duong Veasna, Cappelle Julien, Ong Sivuth, Kerleguer Alexandra, Ly Sowath, Tarantola Arnaud, Horwood Paul F, Sakuntabhai Anavaj, Dussart Philippe, Buchy Philippe
Institut Pasteur in Cambodia, International Network of Pasteur Institutes, Virology Unit, Phnom Penh, Cambodia.
Institut Pasteur in Cambodia, International Network of Pasteur Institutes, Epidemiology and Public Health Unit, Phnom Penh, Cambodia; Centre de coopération internationale en recherche agronomique pour le développement (CIRAD), Département ES, Unité AGIRs, Montpellier, France.
Int J Infect Dis. 2017 Feb;55:38-44. doi: 10.1016/j.ijid.2016.12.022. Epub 2016 Dec 28.
This study aimed to investigate proteinuria occurring during dengue disease in children and assess if measurement of this parameter can help physicians in the clinical management of patients.
Proteinuria was assessed by dipstick and quantified by urine protein:creatinine ratio (UPCR) in samples from patients hospitalized with a confirmed dengue infection and in healthy controls.
The dipstick tested positive in 42.9% of the patients presenting at hospital with dengue versus 20.0% in healthy controls. UPCR increased during the critical phase of the disease; peaking one week after fever onset then decreasing as the patients recovered. Patients with warnings signs or severe dengue were more likely to present with proteinuria detected by UPCR at the time of hospital admission compared to patients without warning signs. The sensitivity of this marker, however, was limited as only 16.1% of the patients with warning signs had proteinuria.
Urine dipstick and UPCR do not seem to be very valuable for the triage of the patients at the time of the initial consultation but the observation of a decrease of the UPCR during the course of the illness appears to indicate an evolution towards recovery.
本研究旨在调查儿童登革热疾病期间出现的蛋白尿情况，并评估该参数的测量是否有助于医生对患者进行临床管理。
通过试纸条评估蛋白尿，并对确诊为登革热感染的住院患者和健康对照的样本进行尿蛋白：肌酐比值（UPCR）定量。
在医院就诊的登革热患者中，42.9%的患者试纸条检测呈阳性，而健康对照中这一比例为20.0%。UPCR在疾病的关键阶段升高；在发热开始一周后达到峰值，然后随着患者康复而下降。与没有警示标志的患者相比，有警示标志或重症登革热的患者在入院时通过UPCR检测出蛋白尿的可能性更高。然而，该标志物的敏感性有限，因为只有16.1%有警示标志的患者出现蛋白尿。
在初次会诊时，尿试纸条和UPCR对患者的分诊似乎不太有价值，但在疾病过程中观察到UPCR下降似乎表明病情正在向康复发展。
