Tropical and Infectious Diseases Consultant, Pondok Indah Hospital, Jakarta, Indonesia.
Division of Tropical and Infectious Diseases, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo National Hospital (RSCM), Jakarta, Indonesia.
PLoS One. 2018 Oct 17;13(10):e0205965. doi: 10.1371/journal.pone.0205965. eCollection 2018.
A prominent histopathological feature of fatal dengue cases is hepatic steatosis. However, the association between hepatic steatosis and dengue severity is unknown. We conducted a study to determine the associations of nonalcoholic fatty liver disease (NAFLD) with laboratory markers of dengue severity and length of hospital stay (LOS). A retrospective study was conducted at a private hospital in Jakarta, Indonesia, from December 2011 to December 2016. Bivariate analysis was performed to analyze the associations of laboratory markers of dengue severity and LOS with the presence or absence of NAFLD in no-plasma-leakage (no leakage) and plasma-leakage (leakage) groups. There were 267 dengue-infected patients included in this study. Of these patients, 115 (43.1%) were classified as belonging to the no leakage group, and 152 (56.9%) were classified as belonging to the leakage group. Of the 115 patients belonging to the no leakage group, 53 (46.1%) did not have NAFLD, and 62 (53.9%) had NAFLD. Of the 152 patients belonging to the leakage group, 85 (55.9%) did not have NAFLD, and 67 (44.1%) had NAFLD. Leakage group patients with NAFLD experienced significantly higher hemoconcentration severity (p = 0.04), lower platelet count (p = 0.004) and higher LOS (p = 0.042) than did leakage group patients without NAFLD. The presence of NAFLD in dengue-infected patients with plasma leakage was associated with more severe hemoconcentration, thrombocytopenia and prolonged hospital stay.
致命登革热病例的一个突出组织病理学特征是肝脂肪变性。然而，肝脂肪变性与登革热严重程度之间的关系尚不清楚。我们进行了一项研究，以确定非酒精性脂肪性肝病（NAFLD）与登革热严重程度的实验室标志物和住院时间（LOS）之间的关系。这项回顾性研究在印度尼西亚雅加达的一家私立医院进行，时间为 2011 年 12 月至 2016 年 12 月。进行了双变量分析，以分析无血浆渗漏（无渗漏）和血浆渗漏（渗漏）组中登革热严重程度和 LOS 的实验室标志物与 NAFLD 存在与否之间的关系。本研究共纳入 267 例登革热感染患者。这些患者中，115 例（43.1%）被归类为无渗漏组，152 例（56.9%）被归类为渗漏组。在 115 例无渗漏组患者中，53 例（46.1%）无 NAFLD，62 例（53.9%）有 NAFLD。在 152 例渗漏组患者中，85 例（55.9%）无 NAFLD，67 例（44.1%）有 NAFLD。渗漏组伴有 NAFLD 的患者血液浓缩严重程度显著更高（p=0.04），血小板计数显著更低（p=0.004），住院时间显著更长（p=0.042）。与无 NAFLD 的渗漏组患者相比，血浆渗漏的登革热感染患者中存在 NAFLD 与更严重的血液浓缩、血小板减少和延长住院时间有关。
