中华全科医师杂志
中華全科醫師雜誌
중화전과의사잡지
CHINESE JOURNAL OF GENERAL PRACTITIONERS
2011年
2期
126-128
,共3页
张济祥%段小华%郑承泽%程进%王重新
張濟祥%段小華%鄭承澤%程進%王重新
장제상%단소화%정승택%정진%왕중신
疟疾%血小板减少
瘧疾%血小闆減少
학질%혈소판감소
Malaria%Thrombocytopenia
对61例输入性疟疾的临床资料进行回顾性分析,结果示间日疟带虫组(35例)仅存在轻度的肝损害,间日疟发作组(20例)及恶性疟组(6例)入院前误诊率分别为30%、3/6,同时二组分别有80%、4/6的患者发生血小板减少,C反应蛋白均显著升高.间日疟发作组血小板减少程度与C反应蛋白呈负相关(r=-0.555,P<0.05);恶性疟组有2例发生黑尿热,其中1例发生急性肾衰竭.血小板减少是疟疾发作的标志之一,恶性疟易发生严重并发症.
對61例輸入性瘧疾的臨床資料進行迴顧性分析,結果示間日瘧帶蟲組(35例)僅存在輕度的肝損害,間日瘧髮作組(20例)及噁性瘧組(6例)入院前誤診率分彆為30%、3/6,同時二組分彆有80%、4/6的患者髮生血小闆減少,C反應蛋白均顯著升高.間日瘧髮作組血小闆減少程度與C反應蛋白呈負相關(r=-0.555,P<0.05);噁性瘧組有2例髮生黑尿熱,其中1例髮生急性腎衰竭.血小闆減少是瘧疾髮作的標誌之一,噁性瘧易髮生嚴重併髮癥.
대61례수입성학질적림상자료진행회고성분석,결과시간일학대충조(35례)부존재경도적간손해,간일학발작조(20례)급악성학조(6례)입원전오진솔분별위30%、3/6,동시이조분별유80%、4/6적환자발생혈소판감소,C반응단백균현저승고.간일학발작조혈소판감소정도여C반응단백정부상관(r=-0.555,P<0.05);악성학조유2례발생흑뇨열,기중1례발생급성신쇠갈.혈소판감소시학질발작적표지지일,악성학역발생엄중병발증.
Clinical data of 61 cases of imported malaria were analyzed retrospectively.Patients with malaria were divided into three groups,asymptomatic tertian (vivax) malaria,symptomatic tertian malaria and pernicious (falciparum) malaria.Only mild hepatic damage occurred in some patients with asymptomatic tertian malaria,compared with other groups Symptomatic tertian malaria and pernicious malaria were misdiagnosed in 6 of 20 and three of six,respectively before hospitalization,and 16 of 20 and four of six patients complicated with thrombocytopenia,respectively,and both of them had increased serum level of C-reactive protein (CRP).Platelet count negatively correlated with their serum level of CRP significantly in patients with symptomatic tertian malaria (r =-0.555,P < 0.05).Routine anti-malaria therapy was used in imported malaria,blackwater fever occurred in two patients and acute renal failure occurred in one with falciparum malaria.It is suggested plasmodium exam ination in peripheral blood should be performed in all persons returned from countries prevalent with malaria,thrombocytopenia is an indicator of acute malaria,and more severe complications usually tend to occur in falciparum malaria.