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斯里兰卡儿童登革热感染的临床和生化特征

Clinical and Biochemical Characteristics of Dengue Infections in Children From Sri Lanka.

作者信息

Jayarajah Umesh, Madarasinghe Manohari, Hapugoda Damayanthi, Dissanayake Upul, Perera Lakshika, Kannangara Vibhavee, Udayangani Champika, Peiris Ranga, Yasawardene Pamodh, De Zoysa Ishan, Seneviratne Suranjith L

机构信息

Dengue Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka.

Dengue Research Group, Colombo, Sri Lanka.

出版信息

Glob Pediatr Health. 2020 Nov 22;7:2333794X20974207. doi: 10.1177/2333794X20974207. eCollection 2020.

Abstract

INTRODUCTION

Analyzing dengue disease patterns from different parts of the world should help us formulate more evidence based treatment guidelines and appropriately allocate limited healthcare resources. Therefore, we described the disease characteristics of hospitalised pediatric patients with dengue infections from Sri Lanka during the 2017 dengue epidemic.

METHODS

Clinical and biochemical characteristics of pediatric dengue patients treated at a secondary care hospital in Sri Lanka from 1 June 2017 to 31 August 2017 were analyzed. Our findings were compared with previous pediatric dengue studies in Asia.

RESULTS A TOTAL OF 305: patients (number of males = 184(60%); mean age = 8.6 years) were analyzed. DF (Dengue Fever)-245 (80.3%), DHF (Dengue Hemorrhagic fever)-I:52 (17%), DHF-II:7 (2.3%), and DHF-III:1 (0.3%). Significant associations were found between DHF and abdominal symptoms/signs and overt bleeding manifestations ( < .001). Time of onset of the critical phase was variable (Day 3: 12%, Day 4-5: 78%, Day 6: 5%, and Day 7: 5%). Platelet and white-cell counts (WBC) were significantly lower in DHF than DF; liver enzyme derangement was mild and was similar in the DHF and DF subgroups. None had cardiac, renal, or neurological manifestations and all recovered uneventfully.

CONCLUSION

In Sri Lankan pediatric dengue patients, we found abdominal symptoms and signs, decreased WBC and platelet counts and bleeding manifestations were to be significantly associated with DHF. Liver enzyme derangement did not predict DHF. The time of onset of the critical phase was difficult to predict due to the considerable variations noted.

摘要

引言

分析来自世界不同地区的登革热疾病模式应有助于我们制定更具循证性的治疗指南,并合理分配有限的医疗资源。因此,我们描述了2017年登革热疫情期间斯里兰卡住院的登革热感染儿科患者的疾病特征。

方法

分析了2017年6月1日至2017年8月31日在斯里兰卡一家二级护理医院接受治疗的儿科登革热患者的临床和生化特征。我们的研究结果与亚洲先前的儿科登革热研究进行了比较。

结果

共分析了305例患者(男性184例(60%);平均年龄8.6岁)。登革热(DF)-245例(80.3%),登革出血热(DHF)-I:52例(17%),DHF-II:7例(2.3%),DHF-III:1例(0.3%)。发现DHF与腹部症状/体征及明显出血表现之间存在显著关联(P<0.001)。关键期的发病时间各不相同(第3天:12%,第4 - 5天:78%,第6天:5%,第7天:5%)。DHF患者的血小板和白细胞计数(WBC)显著低于DF患者;肝酶紊乱较轻,DHF和DF亚组相似。无一例有心脏、肾脏或神经方面的表现,所有患者均顺利康复。

结论

在斯里兰卡儿科登革热患者中,我们发现腹部症状和体征、白细胞和血小板计数降低以及出血表现与DHF显著相关。肝酶紊乱不能预测DHF。由于观察到的显著差异,关键期的发病时间难以预测。

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