Castilho Bruna M, Silva Marcus T, Freitas André R R, Fulone Izabela, Lopes Luciane Cruz
School of Pharmaceutical Sciences, São Paulo State University (UNESP), Araraquara, São Paulo, Brazil.
Pharmaceutical Sciences Graduate Course, University of Sorocaba (UNISO), Sorocaba, São Paulo, Brazil.
BMJ Open. 2020 Sep 13;10(9):e035120. doi: 10.1136/bmjopen-2019-035120.
Some patients with dengue fever tend to develop thrombocytopenia during the course of infection and are thus vulnerable to haemorrhagic manifestations and other complications. However, the factors associated with the development of thrombocytopenia are unknown. We aimed to identify factors associated with an increased risk of thrombocytopenia and haematological changes in patients with confirmed dengue fever.
Retrospective cohort study.
Brazilian multicentre primary care databases.
387 patients had positive laboratory serological confirmation of dengue infection during 2014. The data were identified from two databases: Notification of Injury Information System (SINAN) and Municipal Laboratory.
The presence of thrombocytopenia (platelet count <1 50×10/L). The associations of factors that predisposed patients to thrombocytopenia and haematological changes were analysed using logistic regression. ORs and 95% CIs were calculated.
Among 387 patients, 156 had both dengue and thrombocytopenia. The risk factors associated with thrombocytopenia included male sex (OR: 1.77, 95% CI: 1.16 to 2.71, p=0.007), age of 46-64 years (OR: 2.20, 95% CI: 1.15 to 4.21, p=0.009) or ≥65 years (OR: 3.02, 95% CI: 1.40 to 6.50, p=0.002), presence of leucopenia (OR: 6.85, 95% CI: 4.27 to 10.99, p<0.001) and high mean corpuscular haemoglobin (MCH) levels (OR: 2.00, 95% CI: 1.29 to 3.12, p=0.005).
Older age, male sex, presence of leucopenia and high MCH levels were identified as risk factors associated with the development of thrombocytopenia in this population.
一些登革热患者在感染过程中容易出现血小板减少，因此易出现出血表现及其他并发症。然而，与血小板减少发生相关的因素尚不清楚。我们旨在确定确诊登革热患者中与血小板减少风险增加及血液学变化相关的因素。
回顾性队列研究。
巴西多中心初级保健数据库。
2014年期间387例患者实验室血清学确诊登革热感染。数据来自两个数据库：伤害信息通报系统（SINAN）和市立实验室。
血小板减少（血小板计数<150×10/L）的存在情况。使用逻辑回归分析使患者易发生血小板减少和血液学变化的因素之间的关联。计算比值比（OR）和95%置信区间（CI）。
387例患者中，156例同时患有登革热和血小板减少。与血小板减少相关的危险因素包括男性（OR：1.77，95%CI：1.16至2.71，p=0.007）、46 - 64岁年龄组（OR：2.20，95%CI：1.15至4.21，p=0.009）或≥65岁年龄组（OR：3.02，95%CI：1.40至6.50，p=0.002）、白细胞减少的存在（OR：6.85，95%CI：4.27至10.99，p<0.001）以及高平均红细胞血红蛋白（MCH）水平（OR：2.00，95%CI：1.29至3.12，p=0.005）。
在该人群中，年龄较大、男性、白细胞减少的存在以及高MCH水平被确定为与血小板减少发生相关的危险因素。
