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首页> 外文期刊>Journal of Clinical Medicine Research >Simple Prognostic Criteria Can Definitively Identify Patients Who Develop Severe Versus Non-Severe Dengue Disease, or Have Other Febrile Illnesses
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Simple Prognostic Criteria Can Definitively Identify Patients Who Develop Severe Versus Non-Severe Dengue Disease, or Have Other Febrile Illnesses

机译：简单的预后标准可以明确地确定患有严重与非严重登革热疾病或患有其他高热疾病的患者

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Background: Severe dengue disease (SDD) (DHF/DSS: dengue hemorrhagic fever/dengue shock syndrome) results from either primary or secondary dengue virus (DENV) infections, which occur 4 - 6 days after the onset of fever. As yet, there are no definitive clinical or hematological criteria that can specifically identify SDD patients during the early acute febrile-phase of disease (day 0 - 3:?less than?72 hours). This study was performed during a SDD (DHF/DSS) epidemic to: 1) identify the DENV serotypes that caused SDD during primary or secondary DENV infections; 2) identify simple clinical and hematological criteria that could significantly discriminate between patients who subsequently developed SDD versus non-SDD (N-SDD), or had a non-DENV fever of unknown origin (FUO) during day 0 - 3 of fever; 3) assess whether DENV serotype co-infections resulted in SDD. Methods: First serum samples, with clinical and hematological criteria, were collected from 100 patients during the early acute febrile-phase (day 0 - 3:?less than?72 hours), assessed for DENV or FUO infections by IgM- and IgG-capture ELISAs on paired serum samples and by DENV isolations, and subsequently graded as SDD, N-SDD or FUO patients.?Results: In this study: 1) Thirty-three patients had DENV infections, predominantly secondary DENV-2 infections, including each SDD (DHF/DSS) case; 2) Secondary DENV-2/-3 and DENV-2/-4 serotype co-infections however resulted in N-SDD; 3) Each patient who subsequently developed SDD, but none of the others, displayed three clinical criteria: abdominal pain, conjunctival injection and veni-puncture bleeding, therefore each of these criteria provided definitively significant prognostic (P?less than?0.001) values; 4) Petechia, positive tourniquet tests and hepatomegaly, and neutrophilia or leukopenia also significantly identified those who: a) subsequently developed SDD versus N-SDD, or had a FUO; b) subsequently developed SDD versus N-SDD; c) subsequently developed N-SDD versus FUOs, respectively. Conclusions: This is the first report of simple definitively prognostic criteria for SDD patients, including the first assessment and confirmation of conjunctival injection. The three definitive clinical criteria used alone, or supported by the other four criteria, could be essential for specifically identifying those patients needing prompt hospital-based therapies to lessen or avert SDD, without unnecessary hospitalization of the other patients.doi:10.4021/jocmr694w
机译：背景：严重的登革热疾病（SDD）（DHF / DSS：登革出血热/登革热休克综合征）是由原发性或继发性登革热病毒（DENV）感染引起的，感染发生于发烧后4-6天。迄今为止，尚无明确的临床或血液学标准可在疾病的早期急性发热期（第0-3天：少于72小时）明确识别SDD患者。这项研究是在SDD（DHF / DSS）流行期间进行的，目的是：1）确定在原发或继发DENV感染期间引起SDD的DENV血清型; 2）确定简单的临床和血液学标准，这些标准可以显着地区分随后发生SDD的患者与非SDD（N-SDD）的患者，或者在发烧的第0天至第3天发源于非DENV的未知来源的非发烧患者（FUO）; 3）评估DENV血清型共感染是否导致SDD。方法：从早期急性发热期（第0-3天：少于72小时）的100例患者中收集第一份具有临床和血液学标准的血清样本，通过IgM-和IgG-评估DENV或FUO感染结果：在本研究中：1）33例患者患有DENV感染，主要是继发性DENV-2感染，包括每例DENV-2感染。 SDD（DHF / DSS）案件; 2）然而，继发性DENV-2 / -3和DENV-2 / -4血清型共感染导致了N-SDD; 3）每位随后发生SDD的患者，但没有其他患者，表现出三个临床标准：腹痛，结膜注射和静脉穿刺出血，因此，这些标准中的每一个均提供了明确的预后（P≤0.001）值; 4）Petechia，止血带试验阳性和肝肿大，嗜中性粒细胞减少或白细胞减少症也明显地识别出以下患者：a）随后发展了SDD与N-SDD或患有FUO; b）随后开发了SDD与N-SDD; c）随后分别开发了N-SDD与FUO。结论：这是针对SDD患者的简单明确的预后标准的首次报道，包括对结膜注射的首次评估和确认。单独使用这三个确定性临床标准，或由其他四个标准支持，对于特定地识别那些需要迅速的基于医院的治疗以减少或避免SDD的患者，而无需其他患者的不必要住院而言，这可能是必不可少的。doi：10.4021 / jocmr694w

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