摘要
目的探讨儿童重症疟疾的临床特征,提高早期诊断和治疗水平。方法对2005年6月—2006年5月在尼日尔马拉迪省中心医院儿科住院的156例<5岁重症疟疾患儿的临床表现、实验室检查及临床转归进行回顾性分析。结果重度贫血(45.51%)、高乳酸血症(23.72%)、脑型疟疾(23.08%)、血小板减少(21.15%)、低血糖(21.15%)、高原虫血症(12.18%)、呼吸窘迫(11.54%)是本组患儿的特征性临床表现。2岁以下患儿重度贫血的发生率显著高于2～5岁患儿,差异有统计学意义(P<0.05);而脑型疟疾的发生率2～5岁患儿显著高于2岁以下患儿,差异有统计学意义(P<0.05)。156例患儿中恶性疟的发病人数占显著优势,为113例(72.44%),三日疟25例(16.02%),卵形疟16例(10.26%),间日疟2例(1.28%)。死亡28例(17.95%)。脑型疟疾、惊厥、低血糖、高乳酸血症是患儿死亡的独立高危因素(P<0.05)。结论尼日尔地区儿童重症疟疾主要为恶性疟,重度贫血和脑型疟疾常见,并与患儿年龄相关。脑型疟疾、惊厥、低血糖、高乳酸血症是患儿死亡的独立高危因素。
Objective To investigate clinical features of severe malaria in children so as to improve early diagnosis and treatment of the disease.Methods The clinical manifestations,laboratory testing and clinical outcomes of 156 patients,aged younger than 5 years old,with severe malaria were collected from June 2005 to May 2006 in the pediatric department of the Centre Hospital of Maradi in Niger,were retrospectively analyzed.Results Severe anaemia(45.51%),hyperlactataemia(23.72%),cerebral malaria(23.08%),thrombocytopenia(21.15%),hypoglycaemia(21.15%),hyperparasitaemia(12.18%),respiratory distress(11.54%)were characteristics of clinical manifestations in these children.The incidence of severe anemia in aged younger than 2-year-old children was significantly higher than that in aged 2-5 years old children,while the incidence of cerebral malaria in 2-5 years old children was significantly higher than those younger than 2-year-old(all P < 0.05).One hundred and thirteen cases(72.44%)were falciparum malaria that accounted for the majority of children with malaria,25 cases(16.02%)were plasmodium malariae,16 cases(10.26%)were plasmodium ovale,and 2 cases(1.28%)were plasmodium vivax.In 156 cases,28 patients(17.95%)died.Cerebral malaria,convulsions,hypoglycemia,hyperlactataemia were independent risk factors for death in children with statistical significance(P < 0.05).Conclusions Severe malaria in children in Niger was mainly caused by plasmodium falciparum infection.Severe anemia and cerebral malaria in children were common and age-related.Cerebral malaria,convulsions,hypoglycemia,hyperlactataemia are independent risk factors for death in children.
出处
《临床儿科杂志》
CAS
CSCD
北大核心
2012年第2期153-156,共4页
Journal of Clinical Pediatrics
关键词
疟疾
临床特征
儿童
尼日尔
malaria
clinical feature
child
Niger
