CAJ | 학술논문

目的对比研究马里人与在马里华人罹患危重恶性疟后的特点,并探讨可能机制.方法对照研究.华人恶性疟患者(n=28)与马里恶性疟患者(n=35)进行对比,分别记录患者基本情况、格拉斯哥昏迷评分(Glasgow coma scale,GCS)、APACHEⅡ评分、呼吸机应用时间及ICU治疗时间、治疗前及治疗后1、3、7d化验室检查[疟原虫检测、血常规、肝肾功能、C-反应蛋白(CRP)等]、头部CT等检查及病死率,观察疾病特点.结果中马危重恶性疟患者构成不同,马里患者病情严重;疟原虫数量、血常规三系、肝肾功能及CRP水平呈动态变化,马里患者变化较大,APACHEⅡ评分与CRP水平有相关性(r0 =0.5,r1=0.6,r3=0.7,r7=0.5) (P＜0.05);重症患者头部CT可呈局灶性缺血改变;两组病死率分别为16.7％和25.0％.结论中国与马里恶性疟患者人群构成有不同,马里患者病情严重;病情程度可能与感染后机体免疫反应相关.
목적 대비연구마리인여재마리화인리환위중악성학후적특점,병탐토가능궤제.방법 대조연구.화인악성학환자(n=28)여마리악성학환자(n=35)진행대비,분별기록환자기본정황、격랍사가혼미평분(Glasgow coma scale,GCS)、APACHEⅡ평분、호흡궤응용시간급ICU치료시간、치료전급치료후1、3、7d화험실검사[학원충검측、혈상규、간신공능、C-반응단백(CRP)등]、두부CT등검사급병사솔,관찰질병특점.결과 중마위중악성학환자구성불동,마리환자병정엄중;학원충수량、혈상규삼계、간신공능급CRP수평정동태변화,마리환자변화교대,APACHEⅡ평분여CRP수평유상관성(r0 =0.5,r1=0.6,r3=0.7,r7=0.5) (P＜0.05);중증환자두부CT가정국조성결혈개변;량조병사솔분별위16.7％화25.0％.결론 중국여마리악성학환자인군구성유불동,마리환자병정엄중;병정정도가능여감염후궤체면역반응상관.
Objective To investigate the clinical features and the mechanism of falciparum malaria in several patients between Chinese and Malian.Methods The data of Chinese (n =28) and Malian patients (n =35) including general condition,Glasgow Coma Scale (GCS),APACHE Ⅱ,the time of applying ventilator and days of stay in ICU,laboratory examination (plasmodium test,routine blood test,liver and kidney function and C-reactive protein (CRP) assayed before treatment and 1d,3d,7d after treatment,cranial computed tomography and mortality were recorded for investigating the clinical features of the disease.Results There was difference in age range between Chinese patients (ranged from 32 to 50 years old) and Malian patients (ranged from 8 to 72 years old),and difference in severity of the disease between patients of two countries was found and Malian patients were more severely infected than Chinese patients.The results of plasmodium test,routine blood test,liver and kidney function and level of CRP often varied greatly during the entire course of the disease,and the changes were greater in Malian patients.The correlation between APACHE Ⅱ and CRP was found (P ＜ 0.05).The cranial CT displayed ischemia focus in brain.The mortality of Chinese patients was 16.7％ and that of Malian was 25.0％.Conclusions There was difference in composition of residents between Chinese patients and Malian patients.Malian patients were more severely infected with Plasmodium falciparum than Chinese patients,and this difference might be due to the potential correlation between the disease virulence and immune response of patients.