中国登革热感染的临床特征与实验室指标:对一家中医医院成年患者的回顾性研究
Clinical features and laboratory indicators of dengue infection in China: a retrospective study of adult patients in a hospital of traditional Chinese medicine.
作者信息
Nie Qilong, Li Mingyang, Liang Qiuyan, Ren Jian, Li Tong, Peng Wenya, Luo Cuifen, Mo Xiaoai, Ma Xiaojun, Li Jianhong, Jiang Kaiping
机构信息
The Eighth Clinical Medical College, Guangzhou University of Chinese Medicine, Foshan, Guangdong, China.
Foshan Hospital of Traditional Chinese Medicine, Foshan, Guangdong, China.
出版信息
Front Med (Lausanne). 2025 Jul 7;12:1624554. doi: 10.3389/fmed.2025.1624554. eCollection 2025.
BACKGROUND
Dengue is an arboviral disease caused by the dengue virus, primarily transmitted by mosquitoes in tropical and subtropical regions. Despite preventive measures, the incidence and mortality of dengue remain significant. While the acute phase of infection often presents with mild, self-limiting symptoms and may mimic other undifferentiated febrile illnesses, the risk of mortality is particularly high during the acute phase of secondary infections, which are associated with more severe clinical manifestations. Liver dysfunction has been strongly linked to the severity of the disease, and it plays a critical role in determining patient outcomes.
METHODS
This retrospective observational study was conducted at Foshan Hospital of Traditional Chinese Medicine, including 533 hospitalized dengue patients diagnosed between June and December 2024. Clinical symptoms (e.g., fatigue, headache, muscle pain, dry mouth, rash, nausea) and laboratory parameters (e.g., complete blood count, liver function tests, lactate dehydrogenase, C-reactive protein, procalcitonin) were collected. Patients were categorized into three groups based on liver function test results: non-liver injury (ALT ≤ 40 U/L, AST ≤ 40 U/L), mild liver injury (ALT or AST levels between 40 U/L and 80 U/L), and severe liver injury (ALT > 80 U/L or AST > 80 U/L).
RESULTS
Among the 533 patients, 48.03% were male and 51.97% were female, with the majority (61.35%) in the 51-80 years age range. Common clinical symptoms included fatigue (92.50%), poor appetite (90.99%), dry mouth (62.66%), and headache (52.53%). Significant laboratory abnormalities included leukopenia (63.41%), thrombocytopenia (80.11%), and elevated liver enzymes (AST 84.99%, ALT 52.53%). Stratification based on liver injury severity showed that the severe liver injury group had significantly higher levels of inflammatory markers (CRP, PCT), and tissue damage markers (LDH, CK) compared to the non-liver injury and mild liver injury groups. The severe liver injury group also had a younger median age compared to the other two groups ( < 0.05). Additionally, bone joint pain and melena were more frequently observed in the severe liver injury group, highlighting their association with liver injury severity.
CONCLUSION
Dengue patients commonly present with symptoms such as fatigue, poor appetite, and dry mouth, with laboratory abnormalities including leukopenia, thrombocytopenia, and elevated liver enzymes.
背景
登革热是一种由登革病毒引起的虫媒病毒病,主要在热带和亚热带地区通过蚊子传播。尽管采取了预防措施,但登革热的发病率和死亡率仍然很高。虽然感染急性期通常表现为轻度、自限性症状,可能类似于其他未分化的发热性疾病,但二次感染急性期的死亡风险特别高,二次感染与更严重的临床表现相关。肝功能障碍与疾病的严重程度密切相关,在决定患者预后方面起着关键作用。
方法
这项回顾性观察研究在佛山市中医院进行,纳入了2024年6月至12月期间确诊的533例住院登革热患者。收集了临床症状(如疲劳、头痛、肌肉疼痛、口干、皮疹、恶心)和实验室参数(如全血细胞计数、肝功能检查、乳酸脱氢酶、C反应蛋白、降钙素原)。根据肝功能检查结果将患者分为三组:无肝损伤(谷丙转氨酶≤40 U/L,谷草转氨酶≤40 U/L)、轻度肝损伤(谷丙转氨酶或谷草转氨酶水平在40 U/L至80 U/L之间)和重度肝损伤(谷丙转氨酶>80 U/L或谷草转氨酶>80 U/L)。
结果
在533例患者中,男性占48.03%,女性占51.97%,大多数(61.35%)年龄在51 - 80岁之间。常见临床症状包括疲劳(92.50%)、食欲不佳(90.99%)、口干(62.66%)和头痛(52.53%)。显著的实验室异常包括白细胞减少(63.41%)、血小板减少(80.11%)和肝酶升高(谷草转氨酶84.99%,谷丙转氨酶52.53%)。根据肝损伤严重程度分层显示,与无肝损伤和轻度肝损伤组相比,重度肝损伤组的炎症标志物(CRP、PCT)和组织损伤标志物(LDH、CK)水平显著更高。重度肝损伤组的中位年龄也比其他两组年轻(<0.05)。此外,重度肝损伤组更频繁观察到关节疼痛和黑便,突出了它们与肝损伤严重程度的关联。
结论
登革热患者常见疲劳、食欲不佳和口干等症状,实验室异常包括白细胞减少、血小板减少和肝酶升高。
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