Faiz M A, Rahman M R, Hossain M A, Rashid H A
Deptt. of Medicine, Chittagong Medical College.
Bangladesh Med Res Counc Bull. 1998 Aug;24(2):35-42.
One hundred and four adult cases of cerebral malaria (73 male, 31 female) were studied between July 1995 to June 1996 in Chittagong Medical College Hospital. Diagnosis of cerebral malaria was based on unrousable coma or any neurological manifestation in a febrile patient with asexual Plasmodium falciparum in blood film. Intermittent fever (83%), vomiting (80%), headache (75%), convulsion (60%) and history of travel or residence in malaria endemic area were important features noted in patients with cerebral malaria. Most of the patients (69%) were admitted within 25 to 48 hours following unconsciousness. The factors are more common in cases with high mortality with diastolic blood pressure (DBP) below 60 mm of Hg, anaemia, persistence of Glasgow Coma Score below 5 on day 2, high parasite count at presentation, proteinuria and high level of serum urea. Out of 104 cases of cerebral malaria 66 patients (63.5%) recovered without sequelae, 34 patients (32.7%) died and 4 patients (3.8%) recovered with some residual sequelae. Establishment of intensive care unit in tertiary level hospitals is necessary to take appropriate measure for severe cerebral malaria cases for reduction of mortality.
1995年7月至1996年6月期间，在吉大港医学院医院对104例成人脑型疟病例（男73例，女31例）进行了研究。脑型疟的诊断依据是发热患者血片中存在无性疟原虫，且出现无法唤醒的昏迷或任何神经学表现。间歇性发热（83%）、呕吐（80%）、头痛（75%）、惊厥（60%）以及有疟疾流行地区旅行或居住史是脑型疟患者的重要特征。大多数患者（69%）在昏迷后25至48小时内入院。这些因素在死亡率高的病例中更为常见，包括舒张压低于60毫米汞柱、贫血、第2天格拉斯哥昏迷评分持续低于5分、就诊时寄生虫计数高、蛋白尿以及血清尿素水平高。在104例脑型疟病例中，66例患者（63.5%）康复且无后遗症，34例患者（32.7%）死亡，4例患者（3.8%）康复但有一些残留后遗症。在三级医院设立重症监护病房对于采取适当措施治疗重症脑型疟病例以降低死亡率是必要的。
