Sowunmi A
Department of Pharmacology and Therapeutics, University of Ibadan, Nigeria.
Trans R Soc Trop Med Hyg. 1996 Sep-Oct;90(5):540-2. doi: 10.1016/s0035-9203(96)90313-2.
The characteristics of hepatomegaly in acute falciparum malaria were studied in 114 children presenting consecutively with the disease. Hepatomegaly was more common than splenomegaly and was significantly more frequent in younger than in older children. In children with hepatomegaly at presentation, there was an equal sex distribution, a negative correlation between liver size and age, and a positive correlation between liver enlargement and the reported duration of symptoms at presentation. Symptoms attributable directly to liver involvement were relatively uncommon. There was no correlation between liver and spleen size, presenting core temperature, or peripheral parasite density. Tender hepatomegaly and tender splenomegaly were rare during the acute illness; tenderness resolved within 72 h after commencement of antimalarial therapy. Complete resolution of hepatomegaly occurred in 41% of children after recovery from the acute illness (by days 7 or 14), varying degrees of resolution occurred in 48% and no reduction or an increase in liver size occurred in the remainder. In children with hepatomegaly who failed to clear parasitaemia by days 7 or 14, persistent hepatomegaly was common. These results suggest that hepatomegaly, like splenomegaly, may be assessed as a possible malariometric index of the intensity of transmission in children in an endemic area.
对114例连续就诊的急性恶性疟患儿的肝肿大特征进行了研究。肝肿大比脾肿大更常见，且在年幼儿童中明显比年长儿童更频繁。就诊时有肝肿大的儿童中，性别分布均衡，肝脏大小与年龄呈负相关，肝脏肿大与就诊时报告的症状持续时间呈正相关。直接归因于肝脏受累的症状相对少见。肝脏和脾脏大小、就诊时的核心体温或外周寄生虫密度之间无相关性。急性病期间压痛性肝肿大和压痛性脾肿大很少见；抗疟治疗开始后72小时内压痛消失。41%的儿童在急性病恢复后（第7天或第14天）肝肿大完全消退，48%有不同程度的消退，其余儿童肝脏大小无缩小或增大。在第7天或第14天未能清除寄生虫血症的肝肿大儿童中，持续性肝肿大很常见。这些结果表明，肝肿大与脾肿大一样，可作为评估流行地区儿童疟疾传播强度的一个可能的疟疾测量指标。
