Amodu O K, Adeyemo A A, Olumese P E, Gbadegesin R A
Department of Clinical Pharmacology, University College Hospital, Ibadan, Nigeria.
Trans R Soc Trop Med Hyg. 1998 Jan-Feb;92(1):54-6. doi: 10.1016/s0035-9203(98)90952-x.
Intraleucocytic malaria pigment has been suggested as a measure of disease severity in malaria. We have tested this hypothesis by studying 146 children aged 6 months to 14 years in 4 categories--cerebral malaria, mild malaria, asymptomatic malaria and 'no malaria'--in Ibadan, Nigeria, an area of intense malaria transmission in Africa. Children with cerebral malaria were studied at the university hospital, those with mild malaria at 2 primary health centres and the other 2 groups were studied in a primary school. The proportion of pigment-containing neutrophils showed a clear rise across the spectrum no malaria--asymptomatic malaria--mild malaria--cerebral malaria (median values 2.0%, 6.5%, 9.0% and 27.0%, respectively; P < 0.0001). The proportion of pigment-containing monocytes did not differ significantly between the mild malaria, asymptomatic malaria and no malaria groups but the cerebral malaria group had a higher median value than the other 3 groups. The ratio of pigment-containing neutrophils to pigment-containing monocytes showed the same trend across the groups of subjects as was observed with the number of pigment-containing neutrophils. It is concluded that the pigment-containing neutrophil count is a simple marker of disease severity in childhood malaria in addition to the parasite count.
白细胞内疟色素已被提议作为疟疾疾病严重程度的一项指标。我们通过研究尼日利亚伊巴丹地区146名年龄在6个月至14岁之间的儿童来验证这一假设，这些儿童分为4类——脑型疟疾、轻度疟疾、无症状疟疾和“无疟疾”，伊巴丹是非洲疟疾传播密集的地区。脑型疟疾患儿在大学医院接受研究，轻度疟疾患儿在2个初级卫生中心接受研究，另外两组在一所小学接受研究。含色素中性粒细胞的比例在“无疟疾”——无症状疟疾——轻度疟疾——脑型疟疾这一范围内呈明显上升趋势（中位数分别为2.0%、6.5%、9.0%和27.0%；P<0.0001）。轻度疟疾组、无症状疟疾组和无疟疾组中含色素单核细胞的比例无显著差异，但脑型疟疾组的中位数高于其他3组。含色素中性粒细胞与含色素单核细胞的比例在各受试者组中呈现出与含色素中性粒细胞数量相同的趋势。研究得出结论，除了疟原虫计数外，含色素中性粒细胞计数是儿童疟疾疾病严重程度的一个简单指标。
