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[用于诊断急性水样腹泻婴儿霍乱的临床量表的研制]

[The development of a clinical scale for the diagnosis of cholera in infants with acute watery diarrhea].

作者信息

Miranda-Langschwager P, Salazar-Lindo E, Chea-Woo E, Santisteban-Ponce J

机构信息

Departamento de Pediatría, Universidad Peruana Cayetano Heredia, Lima, Perú.

出版信息

Bol Med Hosp Infant Mex. 1993 Nov;50(11):781-8.

PMID:8274229
Abstract

The diagnosis of cholera in infants based on clinical grounds is often difficult because other enteropathogens such as rotavirus or enterotoxigenic Escherichia coli (ETEC) can produced a very similar clinical picture. We studied 147 infants admitted consecutively to the Rehydration Unit of Cayetano Heredia Hospital in Lima, Perú, trying to identified those characteristics significantly associated with the isolation of Vibrio cholerae 01 on the admission stool culture. After a univariate comparison of cases and controls were selected those characteristics that showed a significantly different distribution. These were entered in a logistic regression model to analyze their interactions. After this analysis four variables remain significantly associated to cases: no history of fever, dehydration greater than 7%, fecal pH greater than 7 and no glucose in feces. Were developed a diagnostic score with these variables, which had a sensitivity of 77.6% and a specificity of 73.6%. It is important to prospectively validate the utility of this score.

摘要

基于临床依据对婴儿霍乱进行诊断往往很困难,因为其他肠道病原体,如轮状病毒或产肠毒素大肠杆菌(ETEC),可产生非常相似的临床表现。我们研究了连续入住秘鲁利马卡耶塔诺·埃雷迪亚医院补液科的147名婴儿,试图确定那些与入院时粪便培养分离出霍乱弧菌O1显著相关的特征。在对病例和对照进行单变量比较后,选择那些分布有显著差异的特征。将这些特征纳入逻辑回归模型以分析它们之间的相互作用。经过该分析,有四个变量与病例仍显著相关:无发热史、脱水超过7%、粪便pH值大于7且粪便中无葡萄糖。利用这些变量制定了一个诊断评分,其敏感性为77.6%,特异性为73.6%。前瞻性验证该评分的效用很重要。

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