Nguyen P H, Day N, Pram T D, Ferguson D J, White N J
Wellcome Trust Clinical Research Unit, Centre for Tropical Diseases, Cho Quan Hospital, Ho Chi Minh City, Viet Nam.
Trans R Soc Trop Med Hyg. 1995 Mar-Apr;89(2):200-4. doi: 10.1016/0035-9203(95)90496-4.
The quantity of malaria pigment liberated into the circulation at schizogony reflects the pathogenic sequestered parasite burden in Plasmodium falciparum malaria, and may therefore be a measure of disease severity. Among 300 consecutive adult patients with severe falciparum malaria, the 40 who died had significantly higher proportions of malaria pigment-containing neutrophils on admission (mean = 7.7%, standard deviation (SD) = 5.9%) and pigment-containing monocytes (mean = 8.6%, SD = 5.9%) than did survivors (mean 3.2%, SD = 4.1% and mean 4.8%, SD = 4.6%, respectively) (P < 0.0001). This proved a better indicator of prognosis than the peripheral parasite count. A count of peripheral neutrophils containing visible pigment > or = 5% predicted a fatal outcome with 73% sensitivity and 77% specificity (relative risk 6.2, 95% confidence interval (CI) 3.2-11.8) compared to 60% sensitivity and 57% specificity for parasitaemia > 100,000/microL (relative risk 1.8, 95% CI 1.0-3.3). The peripheral blood count of pigment-containing neutrophils in severe malaria is a rapid, simple, and practical prognostic test.
裂体增殖时释放到循环系统中的疟色素量反映了恶性疟原虫疟疾中致病性隐匿寄生虫负荷，因此可能是疾病严重程度的一个衡量指标。在300例连续的成年重症恶性疟患者中，40例死亡患者入院时含疟色素的中性粒细胞比例（平均 = 7.7%，标准差（SD）= 5.9%）和含色素的单核细胞比例（平均 = 8.6%，SD = 5.9%）显著高于存活患者（分别为平均3.2%，SD = 4.1%和平均4.8%，SD = 4.6%）（P < 0.0001）。这证明其比外周血寄生虫计数是更好的预后指标。与寄生虫血症>100,000/微升时60%的敏感性和57%的特异性（相对风险1.8，95%置信区间（CI）1.0 - 3.3）相比，外周血中含可见色素的中性粒细胞计数≥5%预测致命结局的敏感性为73%，特异性为77%（相对风险6.2，95%CI 3.2 - 11.8）。重症疟疾患者外周血中含色素中性粒细胞计数是一种快速、简单且实用的预后检测方法。
