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巴西登革热持续症状患者的前瞻性研究。

Prospective study of patients with persistent symptoms of dengue in Brazil.

作者信息

Teixeira Luciana de Almeida Silva, Nogueira Fabiana Prado Dos Santos, Nascentes Gabriel Antonio Nogueira

机构信息

Universidade Federal do Triângulo Mineiro, Programa de Pós-Graduação em Medicina Tropical e Infectologia, Uberaba, Minas Gerais, Brazil.

Instituto Federal de Educação, Ciência e Tecnologia do Triângulo Mineiro, Disciplinas de Microbiologia e Imunologia, Uberaba, Minas Gerais, Brazil.

出版信息

Rev Inst Med Trop Sao Paulo. 2017 Sep 4;59:e65. doi: 10.1590/S1678-9946201759065.

Abstract

Dengue is an arboviral infection clinically recognized as an acute and self-limited disease. Persistence of dengue symptoms is known, but it has been little studied. The aim of this study was to characterize persistent symptoms in 113 patients with dengue followed up clinically and by laboratory testing at a tertiary hospital. Symptoms that persisted for more than 14 days were observed in 61 (54.0%) patients, and six (6.2%) of them had symptoms for 6 months or more. The persistent symptoms identified were myalgia, weakness, hair loss, memory loss, reduced resistance to physical effort, headache, reasoning problems, arthralgia, sleepiness- and emotional lability. The progression to persistent symptoms was significantly associated with hospitalization, older age, more severe disease, the presence of bleeding and comorbidities upon univariate analysis. Upon multivariate analysis, the presence of persistent symptoms continued to be significantly associated only with increased age and dengue with warning signs. The platelet count during the acute phase of the disease was significantly lower in the group with persistent symptoms. In conclusion, the frequency of progression to persistent symptoms in dengue is relevant in patients seen at a tertiary hospital and the persistence of symptoms is more common in patients with dengue with warning signs.

摘要

登革热是一种虫媒病毒感染,临床上被认为是一种急性自限性疾病。登革热症状持续存在的情况是已知的,但相关研究较少。本研究的目的是对一家三级医院临床随访并进行实验室检测的113例登革热患者的持续症状进行特征描述。61例(54.0%)患者出现症状持续超过14天,其中6例(6.2%)症状持续6个月或更长时间。所确定的持续症状包括肌痛、虚弱、脱发、记忆力减退、体力耐力下降、头痛、推理问题、关节痛、嗜睡和情绪不稳定。单因素分析显示,进展为持续症状与住院、年龄较大、病情更严重、出血的存在以及合并症显著相关。多因素分析显示,持续症状的存在仅与年龄增长和有警示体征的登革热仍显著相关。疾病急性期有持续症状的组血小板计数显著更低。总之,在三级医院就诊的患者中,登革热进展为持续症状的频率值得关注,且有警示体征的登革热患者症状持续更常见。

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The global economic burden of dengue: a systematic analysis.登革热的全球经济负担:系统分析。
Lancet Infect Dis. 2016 Aug;16(8):935-41. doi: 10.1016/S1473-3099(16)00146-8. Epub 2016 Apr 16.
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Lancet. 2015 Jan 31;385(9966):453-65. doi: 10.1016/S0140-6736(14)60572-9. Epub 2014 Sep 14.
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Dengue.登革热
N Engl J Med. 2012 Apr 12;366(15):1423-32. doi: 10.1056/NEJMra1110265.

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