脑型疟疾：对发病机制、并发症及分子生物标志物的见解
Cerebral malaria: insight into pathogenesis, complications and molecular biomarkers.
作者信息
Yusuf Farah Hafiz, Hafiz Muhammad Yusuf, Shoaib Maria, Ahmed Syed Ahsanuddin
机构信息
Department of Medicine, Dow Medical College, Dow University of Health Sciences.
Department of Medicine, Sindh Medical College, Jinnah Sindh Medical University, Karachi, Pakistan.
出版信息
Infect Drug Resist. 2017 Feb 2;10:57-59. doi: 10.2147/IDR.S125436. eCollection 2017.
Abstract
Cerebral malaria is a medical emergency. All patients with malaria with neurologic manifestations of any degree should be urgently treated as cases of cerebral malaria. Pathogenesis of cerebral malaria is due to damaged vascular endothelium by parasite sequestration, inflammatory cytokine production and vascular leakage, which result in brain hypoxia, as indicated by increased lactate and alanine concentrations. The levels of the biomarkers' histidine-rich protein II, angiopoietin-Tie-2 system and plasma osteoprotegrin serve as diagnostic and prognostic markers. Brain imaging may show neuropathology around the caudate and putamen. Mortality is high and patients who survive sustain brain injury which manifests as long-term neurocognitive impairments.
摘要
脑型疟疾是一种医疗急症。所有出现任何程度神经学表现的疟疾患者都应作为脑型疟疾病例进行紧急治疗。脑型疟疾的发病机制是由于寄生虫滞留导致血管内皮受损、炎性细胞因子产生和血管渗漏，进而导致脑缺氧，这可通过乳酸和丙氨酸浓度升高来表明。生物标志物富含组氨酸蛋白II、血管生成素-Tie-2系统和血浆骨保护素的水平可作为诊断和预后标志物。脑部成像可能显示尾状核和壳核周围的神经病理学变化。死亡率很高，存活下来的患者会遭受脑损伤，表现为长期神经认知障碍。
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