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登革热和登革出血热患者的凝血异常

Coagulation abnormalities in dengue and dengue haemorrhagic fever patients.

作者信息

Hassan Jawad, Borhany Munira, Abid Madiha, Zaidi Uzma, Fatima Naveena, Shamsi Tahir

机构信息

Department of Hematology, Hemostasis & Thrombosis, National Institute of Blood Disease & Bone Marrow Transplantation, Karachi, Pakistan.

出版信息

Transfus Med. 2020 Feb;30(1):46-50. doi: 10.1111/tme.12658. Epub 2019 Dec 19.

Abstract

OBJECTIVE

The aim of this study was to assess abnormality of coagulation and anticoagulation parameters in dengue fever patients and the impact of these tests on the management of patients.

BACKGROUND

Dengue fever is endemic in Pakistan with seasonal rise in cases. Morbidities and mortalities are proportionately reported to be increasing and associated with disseminated intravascular coagulation resulting in haemorrhagic or thrombotic manifestations in patients having deranged coagulation profiles.

METHODS/MATERIALS: This observational and descriptive study was conducted on confirmed Dengue patients at the National Institute of Blood Diseases during the years 2013 to 2016. Patients of all age groups were included in this study. Results were analysed by SPSS version 23.

RESULTS

A total of 200 patients were selected with the mean age being 28.68 years (±13.28) and male predominance (147/200). The mean platelet count, haemoglobin and haematocrit at base line for bleeders and non-bleeders showed significant results, where platelet count at baseline for bleeders was 24 000, whereas for non-bleeders it was 29 000 and it showed significant correlation with bleeding (P-value .027). Platelets were transfused to 76 (38%) patients. However, none of the specialised haemostasis parameters beside the platelet count correlated with bleeding, requiring platelet transfusions.

CONCLUSION

Our study showed a significant association of platelet counts, haemoglobin and haematocrit with bleeding. It can be concluded that coagulation and anticoagulation profiles will not benefit the management of dengue patients and in countries like Pakistan, it will only add to the economic burden on the patients.

摘要

目的

本研究旨在评估登革热患者凝血和抗凝参数的异常情况以及这些检测对患者管理的影响。

背景

登革热在巴基斯坦呈地方流行,病例数有季节性上升。据报道,发病率和死亡率呈上升趋势,且与弥散性血管内凝血相关,导致凝血功能紊乱的患者出现出血或血栓形成表现。

方法/材料:本观察性描述性研究于2013年至2016年在国家血液疾病研究所对确诊的登革热患者进行。所有年龄组的患者均纳入本研究。结果采用SPSS 23版进行分析。

结果

共选取200例患者,平均年龄为28.68岁(±13.28),男性居多(147/200)。出血者和非出血者基线时的平均血小板计数、血红蛋白和血细胞比容显示出显著差异,出血者基线血小板计数为24000,而非出血者为29000,且与出血有显著相关性(P值为0.027)。76例(38%)患者接受了血小板输注。然而,除血小板计数外,没有其他专门的止血参数与出血相关,也不需要输注血小板。

结论

我们的研究表明血小板计数、血红蛋白和血细胞比容与出血有显著关联。可以得出结论,凝血和抗凝指标对登革热患者的管理并无益处,在巴基斯坦这样的国家,这只会增加患者的经济负担。

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