al-Yaman F, Awburn M M, Clark I A
Department of Biochemistry and Molecular Biology, School of Life Sciences, Australian National University, Australia.
Trans R Soc Trop Med Hyg. 1997 May-Jun;91(3):303-5. doi: 10.1016/s0035-9203(97)90085-7.
Serum from 41 of 92 children admitted to Madang Hospital, Papua New Guinea, with cerebral malaria, previously assessed for serum levels of reactive nitrogen intermediates (RNI: nitrate plus nitrite), were re-assessed for creatinine levels on the day of admission. Further analysis of RNI levels on day 21 compared to day 0 was carried out. Children with the highest RNI levels on admission, and with the longest duration of coma, did not have elevated creatinine levels. The highest levels of creatinine occurred among those with the lightest coma and creatinine levels were similar in those with short (< 48 h) and long (> 48 h) duration of coma. Between days 0 and 21, RNI decreased in 30 of 57 children, increased in 23, and did not change in 4. There was a significant relationship between the decrease in RNI relative to the level of RNI on admission and the duration of coma. For children with a coma duration < 48 h (48/57), there was no difference between the numbers showing an increase or a decrease in RNI level, but 6 of the 9 children with coma duration > 48 h showed a decrease in RNI greater than 50% of the RNI levels on admission. None of these 9 children had elevated creatinine levels. Elevated RNI levels in severe cases were thus not associated with renal function in these children in Papua New Guinea.
巴布亚新几内亚马当医院收治的92名脑型疟患儿中，有41名患儿的血清之前已检测过活性氮中间体（RNI：硝酸盐加亚硝酸盐）水平，此次在入院当天重新检测了肌酐水平。对第21天与第0天的RNI水平进行了进一步分析。入院时RNI水平最高且昏迷持续时间最长的患儿，其肌酐水平并未升高。肌酐水平最高的情况出现在昏迷程度最轻的患儿中，昏迷持续时间短（<48小时）和长（>48小时）的患儿肌酐水平相似。在第0天至第21天期间，57名患儿中有30名RNI水平下降，23名上升，4名无变化。RNI相对于入院时RNI水平的下降与昏迷持续时间之间存在显著关系。对于昏迷持续时间<48小时的患儿（48/57），RNI水平上升或下降的人数没有差异，但9名昏迷持续时间>48小时的患儿中有6名RNI水平下降幅度超过入院时RNI水平的50%。这9名患儿中没有一人肌酐水平升高。因此，在巴布亚新几内亚的这些患儿中，严重病例中升高的RNI水平与肾功能无关。
