登革病毒载量与患者临床特征的关系

Relationship between dengue viral load and clinical characteristics

目的分析登革病毒载量与患者临床特征的关系,为登革热防治提供依据。方法收集2017年6—11月杭州市拱墅区确诊的120例登革热患者临床资料,采用实时荧光定量RT-PCR法检测登革病毒核酸量和分型,分析病毒载量与患者各项临床指标的相关性。结果120例登革热患者登革病毒核酸均为阳性,均为登革热Ⅱ型,登革病毒载量中位数为3.91×10^4 copies/mL。患者均有发热,体温峰值平均为(38.96±0.69)℃;乏力102例,占85.00%;白细胞计数<4×10^9/L 116例,占96.67%;血小板计数<100×10^9/L 119例,占99.17%;谷草转氨酶>40 U/L 114例,占95.00%;谷丙转氨酶>52 U/L 81例,占67.50%;肌酸激酶>210 U/L 58例,占48.33%。登革病毒载量与患者住院时间、体温峰值、发热持续时间、白细胞计数、血小板计数、谷丙转氨酶、谷草转氨酶和肌酸激酶相关性均无统计学意义(P>0.05)。重症患者75例,占62.50%;登革病毒载量中位数为9.29×10^4 copies/mL,高于非重症患者的5.33×10^3 copies/mL(P<0.05)。结论未发现登革病毒载量与患者住院时间、体温峰值、发热持续时间、白细胞计数、血小板计数、谷丙转氨酶和谷草转氨酶、肌酸激酶等临床指标存在相关性。

Objective To determine the relationship between dengue virus load and clinical characteristics,so as to provide basis for dengue fever prevention and treatment.Methods The dengue viral load and typing of 120 patients in Gongshu District of Hangzhou from June to November 2017 were detected by real-time fluorescent quantitative RT-PCR;the clinical indicators of these dengue patients were collected and their correlation with the viral load was analyzed.Results The DNA detection of dengue virus in 120 patients showed that they were all typeⅡ.The median dengue virus load was 3.91×10^4 copies/mL.All the patients had fever,the average peak temperature was(38.96±0.69)℃.There were 102(85.00%)cases with asthenia;116(96.67%)cases with white blood cell count(WBC)less than 4×10^9/L;119(99.17%)cases with platelet count(PLT)less than 100×10^9/L;114(95.00%)cases with glutamic oxaloacetate transaminase(GOT)more than 40 U/L;81(67.50%)cases with glutamic pyruvate transaminase(GPT)more than 52 U/L;58(48.33%)cases with creatine kinase(CK)more than 210 U/L.There was no significant correlation of dengue virus load with length of hospitalization,peak temperature,duration of fever,WBC,PLT,GOT,GPT and CK(P>0.05).There were 75(62.50%)severe patients,and their median viral load was 5.33×10^3 copies/mL,which was higher than 9.29×10^4 copies/mL in non-severe patients(P<0.05).Conclusion The dengue virus load is not related with length of hospitalization,peak temperature,WBC,PLT,GOT,GPT and CK,but with the severity of the disease.