2015-2019年天津市输入性恶性疟病例血检指标与疟原虫感染度关系研究

Association between blood test parameters and intensity of Plasmodium falciparum infections in imported falciparum malaria cases in Tianjin City from 2015 to 2019

目的分析2015-2019年天津市输入性恶性疟病例血检指标与疟原虫感染度间的关系,为输入性恶性疟早期诊断提供参考。方法收集2015-2019年天津市确诊的37例输入性恶性疟病例流行病学个案信息,回顾性分析病例流行病学基本情况及临床表现,分析恶性疟病例血检指标与疟原虫感染度间的关联性。结果 37例输入性恶性疟病例中,31例(83.8%)血小板(PLT)、16例(43.2%)红细胞(RBC)、16例(43.2%)血红蛋白(Hb)降低,23例(62.2%)中性粒细胞百分比(NEUT%)、32例(86.5%)总胆红素(TBIL)、29例(78.4%)天门冬氨酸氨基转移酶(AST)、28例(75.7%)丙氨酸氨基转移酶(ALT)、23例(62.2%)γ-谷氨酰转肽酶(GGT)升高。输入性恶性疟病人PLT、Hb与恶性疟原虫感染程度呈负相关(Goodman-Kruskalγ=-0.568、-0.521,P均<0.05),TBIL、NEUT%与恶性疟原虫感染度呈正相关(Goodman-Kruskalγ=0.496、0.610,P均<0.05),ALT、AST、GGT、RBC与恶性疟原虫感染度无统计学关联(Goodman-Kruskalγ=0.370、0.497、0.314、-0.434,P均> 0.05)。结论 PLT、Hb、TBIL、NEUT%可作为输入性恶性疟早期辅助诊断指标,PLT与了TBIL似可作为诊断重症输入性恶性疟的参考指标。

Objective To evaluate the association between blood test parameters and intensity of Plasmodium falciparum infections among imported falciparum malaria cases in Tianjin City from 2015 to 2019,so as to provide insights into the early diagnosis of imported P.falciparum malaria.Methods The epidemiological data of 37 imported cases with confirmed diagnosis of P.falciparum malaria in Tianjin City from 2015 to 2019 were collected,and the epidemiological features and clinical manifestations were retrospectively analyzed.In addition,the association between blood test parameters and intensity of P.falciparum infections was evaluated among the imported P.falciparum malaria cases.Results Among the 31 imported P.falciparum malaria cases,there were 31 cases(83.8%) with a reduction in platelet(PLT) counts,16 cases(43.2%) with a reduction in red blood cell(RBC) counts,16 cases(43.2%) with a reduction in hemoglobin(Hb) concentrations,23 cases(62.2%) with a rise in neutrophil percentage(NEUT%),32 cases(86.5%) with a rise in total bilirubin(TBIL) concentrations,29 cases(78.4%) with a rise in alanine aminotransferase(ALT) concentrations,28 cases(75.7%) with a rise in aspartate transaminase(AST) concentrations,and 23 cases(62.2%) with a rise in gamma-glutamyl transpetidase(GGT) concentrations.The PLT count and Hb concentration correlated negatively with the intensity of P.falciparum infections(Goodman-Kruskal γ=-0.568 and-0.521,both P values <0.05) and the TBIL concentration and NEUT% correlated positively with the intensity of P.falciparum infections(Goodman-Kruskal γ=0.496 and 0.610,both P values <0.05) among imported falciparum malaria cases;however,there were no associations of ALT,AST,GGT levels or RBC count with the intensity of P.falciparum infections among the imported falciparum malaria cases(Goodman-Kruskal γ=0.370,0.497,0.314 and-0.434,all P values> 0.05).Conclusion PLT,Hb,TBIL and NEUT% may serve as markers for early auxiliary diagnosis of imported P.falciparum malaria,and PLT and TBIL may provide valuable information for the diagnosis of severe imported P.falciparum malaria.