尼泊尔一家三级护理中心的登革热感染的临床病理特征。

Clinicopathological Profile of Dengue Infection in a Tertiary Care Centre in Nepal.

机构信息

Department of Paediatrics, KIST Medical College and Teaching Hospital, Lalitpur, Nepal.

Department of Emergency Medicine, KIST Medical College and Teaching Hospital, Lalitpur, Nepal.

出版信息

J Nepal Health Res Counc. 2023 Jul 20;20(4):859-867. doi: 10.33314/jnhrc.v20i4.4172.

DOI:10.33314/jnhrc.v20i4.4172

PMID:37489668

Abstract

BACKGROUND

Dengue is a mosquito-borne viral disease with a wide spectrum of presentations ranging from subclinical disease to severe dengue. Dengue is endemic to the Terai of Nepal. Interestingly, an increasing incidence has been reported from hilly areas like Kathmandu valley. This study explored the clinicopathological profile of dengue infection.

METHODS

A total of 84 serologically confirmed dengue cases from September to November 2019 at KIST Medical College were recruited in a cross-sectional study after obtaining ethical approval. Dengue was categorized as dengue without warning signs, dengue with warning signs, and severe dengue. Clinicopathological information was recorded in the proforma by reviewing patients' records. A descriptive statistical tool and chi-square test were carried out.

RESULTS

Out of 84 patients, 76% (64) were dengue without warning signs, 21.4% (18) were dengue with warning signs and 2.4% (2) were severe dengue. About 97.6% (82) presented with fever. During the course of illness, anemia was identified in 38.1% (32), thrombocytopenia in 65.5% (55), hemoconcentration in 6% (5), and leucopenia in 82.1% (69). Similarly, elevated aspartate transaminase and alanine transaminase (ALT) was observed in 67.7% (42) and 53.2% (33) respectively. The severity of dengue on presentation to hospital was significantly associated with thrombocytopenia, leucopenia, and elevated ALT. Similarly, the severity during course of illness in hospital was significantly associated with hemoconcentration, thrombocytopenia, leucopenia, and elevated ALT.

CONCLUSIONS

Most common presentation of dengue infection was fever. The most common laboratory abnormalities were leucopenia, thrombocytopenia, hemoconcentration, anemia, and elevated liver enzymes. Awareness of these clinical and laboratory parameters is important for the prompt diagnosis, severity estimation, and overall management of dengue infection.

摘要

背景

登革热是一种由蚊子传播的病毒性疾病，其临床表现范围广泛，从亚临床疾病到严重登革热不等。登革热在尼泊尔的特赖地区流行。有趣的是，据报道，加德满都山谷等丘陵地区的发病率一直在上升。本研究探讨了登革热感染的临床病理特征。

方法

在获得伦理批准后，我们在一项横断面研究中招募了 2019 年 9 月至 11 月在 KIST 医学院经血清学确诊的 84 例登革热患者。登革热分为无预警症状登革热、有预警症状登革热和重症登革热。通过查阅患者病历，在表格中记录临床病理信息。采用描述性统计工具和卡方检验进行分析。

结果

84 例患者中，76%（64 例）为无预警症状登革热，21.4%（18 例）为有预警症状登革热，2.4%（2 例）为重症登革热。约 97.6%（82 例）以发热为首发症状。在疾病过程中，38.1%（32 例）出现贫血，65.5%（55 例）出现血小板减少，6%（5 例）出现血液浓缩，82.1%（69 例）出现白细胞减少。同样，67.7%（42 例）和 53.2%（33 例）分别出现天门冬氨酸转氨酶和丙氨酸转氨酶升高。登革热入院时的严重程度与血小板减少、白细胞减少和 ALT 升高显著相关。同样，住院期间疾病严重程度与血液浓缩、血小板减少、白细胞减少和 ALT 升高显著相关。