Massenet Denis, Couteaux Clément, Goarant Cyrille
Laboratoire de biologie, Hôpital de Sia, Mata'Utu, Wallis et Futuna, France.
Institut Pasteur de Nouvelle-Calédonie, Nouméa, France.
Ann Biol Clin (Paris). 2017 Apr 1;75(2):167-172. doi: 10.1684/abc.2017.1226.
Leptospirosis is a common condition in Wallis and Futuna, and the definitive diagnosis needs to be established urgently at the first patient consultation, which is usually one to two days after the onset of clinical signs. As a diagnostic aid, a composite index was established based on data from 338 patients seen by the Wallis and Futuna admissions services between 2008 and 2015. The data taken into account include: age and sex of the patient, their home island, the consultation period and the results of leukocytes, platelets, CRP, creatinine and GGT tests combined with 2 major clinical signs, headache and conjunctival suffusion. Then 5 threshold limits were defined for this index, which indicates from very low risk to almost certain biologically confirmed leptospirosis. Other febrile diseases responsible for thrombocytopenia are not found in Wallis and Futuna, which probably explains the good statistical qualities of this index with a value of area under the curve equal to 0.821.
钩端螺旋体病在瓦利斯和富图纳群岛是一种常见病症，在首次接诊患者时就需要紧急做出明确诊断，首次接诊通常是在临床症状出现后的一到两天。作为一种诊断辅助手段，基于2008年至2015年间瓦利斯和富图纳群岛住院服务部门接诊的338例患者的数据建立了一个综合指数。考虑的数据包括：患者的年龄和性别、其家乡岛屿、就诊时间以及白细胞、血小板、CRP、肌酐和谷氨酰转肽酶检测结果，并结合头痛和结膜充血这两大主要临床症状。然后为该指数定义了5个阈值范围，该指数表明从极低风险到几乎可以确定为生物学确诊的钩端螺旋体病。在瓦利斯和富图纳群岛未发现其他导致血小板减少的发热性疾病，这可能解释了该指数具有良好统计特性的原因，其曲线下面积值等于0.821。
